Vandiver, Carolyn Jill
Vandiver, Carolyn Jill is an individual health care provider with primary practice located at 1750 North Hampton Road , Desoto TX 75115-2306. She recently has only one registered license in Allopathic & Osteopathic Physicians / Diagnostic Radiology, which is considered as her primary health care specialty. Vandiver, Carolyn Jill can be contacted via phone (214) 946-4397.Contact Information
Primary practice address
1750 North Hampton Road
Desoto TX 75115-2306
Phone: (214) 946-4397
Fax: (214) 946-4399
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Diagnostic Radiology | 2085R0202X | K8548 | Texas |
Profile Details
| NPI number | 1790733475 |
|---|---|
| LBN Legal business name | Vandiver, Carolyn Jill |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 4th, 2006 |
| Last updated | Mar 11th, 2013 - 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 | 1790733475 | NPPES |
| Texas | MEDICAID | 104934803 |
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