MEDICARE: J J CARR MD PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1194810341
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	J J CARR MD PA

Provider Business Mailing Address
First Line	:	PO BOX 260097
Second Line	:
City	:	CORPUS CHRISTI
State	:	TX
Zip	:	78426-0097
Country	:	US
Telephone Number	:	361-767-0303
Fax Number	:	361-761-0303

Provider Business Practice Location Address
First Line	:	13701 NORTHWEST BLVD
Second Line	:	SUITE B1
City	:	CORPUS CHRISTI
State	:	TX
Zip	:	78410-5114
Country	:	US
Telephone Number	:	361-767-0303
Fax Number	:	361-761-0303

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. JEAN-JACQUES CARR
Credential	:	MD
Telephone Number	:	361-767-0303

Provider Enumeration Date	:	10/04/2006
Last Update Date	:	12/04/2007

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