Provider Demographics
NPI:1194083287
Name:ESTELLE, CAROLEE DAWNIELLE (MD)
Entity type:Individual
Prefix:MS
First Name:CAROLEE
Middle Name:DAWNIELLE
Last Name:ESTELLE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 845347
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75284-5347
Mailing Address - Country:US
Mailing Address - Phone:214-590-8000
Mailing Address - Fax:214-645-0078
Practice Address - Street 1:5200 HARRY HINES BLVD
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75390-9087
Practice Address - Country:US
Practice Address - Phone:214-590-8000
Practice Address - Fax:214-645-0078
Is Sole Proprietor?:No
Enumeration Date:2012-04-26
Last Update Date:2018-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX390200000X
TXR5112207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX378969501Medicaid
TX378969502OtherCSHCN