Provider Demographics
NPI:1558012864
Name:POTTMEYER, CARRIE MARIE (PA-C)
Entity type:Individual
Prefix:
First Name:CARRIE
Middle Name:MARIE
Last Name:POTTMEYER
Suffix:
Gender:
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4747 BELLAIRE BLVD STE 550
Mailing Address - Street 2:
Mailing Address - City:BELLAIRE
Mailing Address - State:TX
Mailing Address - Zip Code:77401-4121
Mailing Address - Country:US
Mailing Address - Phone:713-575-3686
Mailing Address - Fax:
Practice Address - Street 1:7619 BRANFORD PL
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77479-7217
Practice Address - Country:US
Practice Address - Phone:713-575-3686
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-18
Last Update Date:2025-03-27
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant