Provider Demographics
NPI:1396206462
Name:CARTER, STORMIE RAE (MD)
Entity type:Individual
Prefix:
First Name:STORMIE
Middle Name:RAE
Last Name:CARTER
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 1:5419 LANCASHIRE DR
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78230-4121
Mailing Address - Country:US
Mailing Address - Phone:817-980-1329
Mailing Address - Fax:
Practice Address - Street 1:3952 PARKVIEW DR
Practice Address - Street 2:
Practice Address - City:CHEYENNE
Practice Address - State:WY
Practice Address - Zip Code:82001-8102
Practice Address - Country:US
Practice Address - Phone:307-637-7700
Practice Address - Fax:855-323-5740
Is Sole Proprietor?:No
Enumeration Date:2019-03-29
Last Update Date:2025-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY15772A207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology