Provider Demographics
NPI:1356408629
Name:WEBB, CARMEN THURSTON (MD)
Entity type:Individual
Prefix:
First Name:CARMEN
Middle Name:THURSTON
Last Name:WEBB
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4409 SORREL CT
Mailing Address - Street 2:
Mailing Address - City:FLOWER MOUND
Mailing Address - State:TX
Mailing Address - Zip Code:75028-8758
Mailing Address - Country:US
Mailing Address - Phone:972-410-1672
Mailing Address - Fax:
Practice Address - Street 1:4100 MCEWEN RD
Practice Address - Street 2:#285
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75244-5113
Practice Address - Country:US
Practice Address - Phone:972-899-1672
Practice Address - Fax:214-254-3762
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH54992084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry