Provider Demographics
NPI:1649268467
Name:CARVAJAL, PATRICIA M (CRNA)
Entity type:Individual
Prefix:MS
First Name:PATRICIA
Middle Name:M
Last Name:CARVAJAL
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:MISS
Other - First Name:PATRICIA
Other - Middle Name:M
Other - Last Name:MCCARTHY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNA
Mailing Address - Street 1:8805 RIDGEHILL DR
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78759-7344
Mailing Address - Country:US
Mailing Address - Phone:512-345-9671
Mailing Address - Fax:512-345-9671
Practice Address - Street 1:8805 RIDGEHILL DR
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78759-7344
Practice Address - Country:US
Practice Address - Phone:512-345-9671
Practice Address - Fax:512-345-9671
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-06
Last Update Date:2007-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX579025367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered