MEDICARE: CARTY-ANNA PATRICE P.A.C.

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	363A00000X	Physician Assistant	PA04923	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	PA04293	OTHER	TX	PA LICENSE

General Provider Information

NPI Number	:	1851309371
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CARTY-ANNA PATRICE P.A.C.

Provider Business Mailing Address
First Line	:	12201 MONTWOOD DR BLDG A
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79938-2620
Country	:	US
Telephone Number	:	915-320-7809
Fax Number	:	915-598-3946

Provider Business Practice Location Address
First Line	:	12201 MONTWOOD DR
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79938-2620
Country	:	US
Telephone Number	:	915-320-7809
Fax Number	:	915-598-3946

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

Provider Enumeration Date	:	08/03/2006
Last Update Date	:	10/03/2024

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Directions to “ CARTY-ANNA PATRICE P.A.C.” Practice Location

Language	Start Address	Practice Location

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