Provider Demographics
NPI:1962413880
Name:CARTER, WILLIAM ROY (DC)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:ROY
Last Name:CARTER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:BILLY
Other - Middle Name:ROY
Other - Last Name:CARTER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RN-C, NP
Mailing Address - Street 1:714 S PALESTINE ST
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:TX
Mailing Address - Zip Code:75751-3325
Mailing Address - Country:US
Mailing Address - Phone:903-675-8889
Mailing Address - Fax:866-252-0069
Practice Address - Street 1:714 S PALESTINE ST
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:TX
Practice Address - Zip Code:75751-3325
Practice Address - Country:US
Practice Address - Phone:903-675-8889
Practice Address - Fax:866-252-0069
Is Sole Proprietor?:No
Enumeration Date:2006-08-10
Last Update Date:2013-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX808100363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00037NMedicare ID - Type Unspecified
TXU74454Medicare UPIN