Provider Demographics
NPI:1861569089
Name:CARR, FREDERIC DEAN (PT)
Entity type:Individual
Prefix:MR
First Name:FREDERIC
Middle Name:DEAN
Last Name:CARR
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3003 QUINCANNON LN
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77043-1201
Mailing Address - Country:US
Mailing Address - Phone:713-562-2575
Mailing Address - Fax:
Practice Address - Street 1:3818 DECKER DR
Practice Address - Street 2:
Practice Address - City:BAYTOWN
Practice Address - State:TX
Practice Address - Zip Code:77520-1662
Practice Address - Country:US
Practice Address - Phone:281-424-7557
Practice Address - Fax:281-424-7567
Is Sole Proprietor?:No
Enumeration Date:2006-11-30
Last Update Date:2021-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1020535225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX7615482OtherAETNA
TX8T1933OtherBLUE CROSS BLUE SHIELD
TX6362783OtherCIGNA
TX634192OtherFIRST HEALTHCCN
TX8T1933OtherBLUE CROSS BLUE SHIELD
TX7615482OtherAETNA