Carter, Elizabeth Wagner
Carter, Elizabeth Wagner is an individual health care provider with primary practice located at 1400 S Main St Lifespan Clinic, Fort Worth TX 76104-4909. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Carter, Elizabeth Wagner can be contacted via phone (817) 702-8360.Contact Information
Primary practice address
1400 S Main St Lifespan Clinic
Fort Worth TX 76104-4909
Phone: (817) 702-8360
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | G0246 | Texas |
Profile Details
| NPI number | 1184613663 |
|---|---|
| LBN Legal business name | Carter, Elizabeth Wagner |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 18th, 2005 |
| Last updated | Dec 17th, 2012 - about 14 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1184613663 | NPPES |
| Texas | Other | 8D9014 | MEDICARE |
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