Carroll, John Raymond
Carroll, John Raymond is an individual health care provider with primary practice located at 2606 Hospital Blvd Ste B , Corpus Christi TX 78405-1804. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Geriatric Medicine. Allopathic & Osteopathic Physicians / Geriatric Medicine is his primary health care specialty. Carroll, John Raymond can be contacted via phone (469) 282-4789.Contact Information
Primary practice address
2606 Hospital Blvd Ste B
Corpus Christi TX 78405-1804
Phone: (469) 282-4789
Fax: (469) 282-4588
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | P9312 | Texas |
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 22136 | Iowa |
| Allopathic & Osteopathic Physicians / Geriatric Medicine | 207QG0300X | P9312 | Texas |
Profile Details
| NPI number | 1992792881 |
|---|---|
| LBN Legal business name | Carroll, John Raymond |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 5th, 2005 |
| Last updated | Apr 12th, 2021 - about 3 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1992792881 | NPPES |
| Texas | Other | 1L5224 | MEDICARE |
| Texas | Other | P02601758 | MEDICARE |
| Texas | MEDICAID | 2196766 | MEDICARE |
| Texas | MEDICAID | 332933605 | MEDICARE |
| Texas | MEDICAID | 332933601 | MEDICARE |
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