Carroll, Tannon Dajuan
Carroll, Tannon Dajuan is an individual health care provider with primary practice located at 301 Seton Pkwy Suite 302, Round Rock TX 78665-8002. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Interventional Cardiology, Allopathic & Osteopathic Physicians / Cardiovascular Disease. Allopathic & Osteopathic Physicians / Interventional Cardiology is his primary health care specialty. Carroll, Tannon Dajuan can be contacted via phone (512) 324-4812.Contact Information
Primary practice address
301 Seton Pkwy Suite 302
Round Rock TX 78665-8002
Phone: (512) 324-4812
Fax: (512) 324-4728
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Interventional Cardiology | 207RI0011X | P7887 | Texas |
| Allopathic & Osteopathic Physicians / Cardiovascular Disease | 207RC0000X | P7887 | Texas |
Profile Details
| NPI number | 1154484715 |
|---|---|
| LBN Legal business name | Carroll, Tannon Dajuan |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 18th, 2006 |
| Last updated | Dec 22nd, 2014 - about 11 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 | 1154484715 | NPPES |
| Texas | MEDICAID | 328854003 | |
| Texas | Other | 8DZ199 | |
| Texas | MEDICAID | 328854004 | |
| Texas | MEDICAID | 328854001 | |
| Texas | Other | 8ET191 |
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