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NPI Code Detail

MEDICARE: MR. PHILIP CAROLINA

MEDICARE: MR. PHILIP CAROLINA
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
1171M00000XCase Manager/Care Coordinator
2101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1508058884
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. PHILIP CAROLINA
Provider Business Mailing Address
First Line : 101 FEU FOLLET RD STE 100
Second Line :
City : LAFAYETTE
State : LA
Zip : 70508-4234
Country : US
Telephone Number : 512-680-2781
Fax Number :
Provider Business Practice Location Address
First Line : 1524 S IH 35 STE 210
Second Line :
City : AUSTIN
State : TX
Zip : 78704-2603
Country : US
Telephone Number : 512-343-8606
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/10/2007
Last Update Date : 10/03/2023

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Directions to “ MR. PHILIP CAROLINA ” Practice Location

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