Quist, Carolyn Wilson

Quist, Carolyn Wilson is an sole proprietor health care provider with primary practice located at 1425 8Th Avenue , Fort Worth TX 76104-4141. She recently has only one registered license in Allopathic & Osteopathic Physicians / Obstetrics & Gynecology, which is considered as her primary health care specialty. Quist, Carolyn Wilson can be contacted via phone (817) 926-1313.

Contact Information

Primary practice address
1425 8Th Avenue Fort Worth TX 76104-4141
Fax: (817) 926-7434
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Obstetrics & Gynecology 207V00000X H2705 Texas

Profile Details

NPI number 1649272972
LBN Legal business name Quist, Carolyn Wilson
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 31st, 2005
Last updated Mar 25th, 2011 - about 13 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1649272972 NPPES
Texas MEDICAID 125509305

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