MEDICARE: MICHAEL LINDSEY CARROLL MD

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	207R00000X	Internal Medicine Physician	F3813	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1487655932
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL LINDSEY CARROLL MD

Provider Business Mailing Address
First Line	:	9208 ELAM RD
Second Line	:	STE 220
City	:	DALLAS
State	:	TX
Zip	:	75217-4178
Country	:	US
Telephone Number	:	214-398-3251
Fax Number	:	214-398-7251

Provider Business Practice Location Address
First Line	:	9208 ELAM RD
Second Line	:	STE 220
City	:	DALLAS
State	:	TX
Zip	:	75217-4178
Country	:	US
Telephone Number	:	214-398-3251
Fax Number	:	214-398-7251

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

Provider Enumeration Date	:	08/09/2005
Last Update Date	:	01/07/2010

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