MEDICARE: CAROL MCVICAR MCFARLAND P.T., PHD

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	225100000X	Physical Therapist	1025559	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	86928T	OTHER	TX	BLUE CROSS BLUE SHIELD

General Provider Information

NPI Number	:	1376624833
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CAROL MCVICAR MCFARLAND P.T., PHD

Provider Business Mailing Address
First Line	:	740 BUNKER DR
Second Line	:
City	:	TYLER
State	:	TX
Zip	:	75703-8871
Country	:	US
Telephone Number	:	903-530-5677
Fax Number	:

Provider Business Practice Location Address
First Line	:	4882 HIGHTECH DR
Second Line	:
City	:	TYLER
State	:	TX
Zip	:	75703-2613
Country	:	US
Telephone Number	:	903-300-0234
Fax Number	:	903-630-9999

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

Provider Enumeration Date	:	10/18/2006
Last Update Date	:	02/17/2022

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