Provider Demographics
NPI:1902869076
Name:ANN CARVER PHYSICAL THERAPY
Entity Type:Organization
Organization Name:ANN CARVER PHYSICAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANN
Authorized Official - Middle Name:M
Authorized Official - Last Name:CARVER
Authorized Official - Suffix:
Authorized Official - Credentials:LPT
Authorized Official - Phone:361-853-6500
Mailing Address - Street 1:2222 AIRLINE RD
Mailing Address - Street 2:STE A-9
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78414-2644
Mailing Address - Country:US
Mailing Address - Phone:361-853-6500
Mailing Address - Fax:361-853-6501
Practice Address - Street 1:2222 AIRLINE RD
Practice Address - Street 2:STE A-9
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78414-2644
Practice Address - Country:US
Practice Address - Phone:361-853-6500
Practice Address - Fax:361-853-6501
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-10
Last Update Date:2013-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX657510000225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX18MXOtherBCBS
TX18MXOtherBCBS