Provider Demographics
NPI:1154592186
Name:WILLIAM M CARPENTER MD PA
Entity type:Organization
Organization Name:WILLIAM M CARPENTER MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:M
Authorized Official - Last Name:CARPENTER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:214-827-8407
Mailing Address - Street 1:4131 N CENTRAL EXPY STE 448
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75204-2188
Mailing Address - Country:US
Mailing Address - Phone:214-827-8407
Mailing Address - Fax:214-827-5001
Practice Address - Street 1:4131 N CENTRAL EXPY STE 448
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75204-2188
Practice Address - Country:US
Practice Address - Phone:214-827-8407
Practice Address - Fax:214-827-5001
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-18
Last Update Date:2021-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH3302174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
00915NMedicare PIN
E23817Medicare UPIN