Provider Demographics
NPI:1144261561
Name:EMERY, CARLA J (DPM, PA)
Entity type:Individual
Prefix:
First Name:CARLA
Middle Name:J
Last Name:EMERY
Suffix:
Gender:F
Credentials:DPM, PA
Other - Prefix:
Other - First Name:CARLA
Other - Middle Name:EMERY
Other - Last Name:CULBERSON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DPM, PA
Mailing Address - Street 1:3303 NORTHLAND DR
Mailing Address - Street 2:SUITE 308
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78731-4945
Mailing Address - Country:US
Mailing Address - Phone:512-420-0808
Mailing Address - Fax:512-420-0969
Practice Address - Street 1:3303 NORTHLAND DRIVE
Practice Address - Street 2:SUITE 308
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78731-4956
Practice Address - Country:US
Practice Address - Phone:512-420-0808
Practice Address - Fax:512-420-0969
Is Sole Proprietor?:No
Enumeration Date:2006-06-09
Last Update Date:2013-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXTX758213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX062914001OtherCIGNA GOVT SVCS
TX00SD10OtherBCBS
TX092842601Medicaid
TX181690OtherUSA MCO HEALTHNET
TX062914001OtherCIGNA GOVT SVCS
TX092842601Medicaid