MEDICARE: DR. LARRY STEVEN CARPENTER M.D.

Medicare Provider Information

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2085R0001X	Radiation Oncology Physician	G8039	TX

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	920002821	OTHER	TX	RR MEDICARE

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	85R092	OTHER	TX	BCBS
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

NPI Number	:	1215929518
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LARRY STEVEN CARPENTER M.D.

Provider Business Mailing Address
First Line	:	11511 SHADOW CREEK PKWY
Second Line	:
City	:	PEARLAND
State	:	TX
Zip	:	77584-7298
Country	:	US
Telephone Number	:	713-442-4997
Fax Number	:

Provider Business Practice Location Address
First Line	:	2525A HOLLY HALL ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77054-4124
Country	:	US
Telephone Number	:	713-526-4243
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/22/2005
Last Update Date	:	06/06/2024

2525 HOLLY HALL ST
HOUSTON, TX
77054-4124

Practice Phone: 713-566-3689
Practice Fax: 713-566-3675