MEDICARE: ALAN LEE CARPENTER D.O.

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	H5697	TX

General Provider Information

NPI Number	:	1972563286
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALAN LEE CARPENTER D.O.

Provider Business Mailing Address
First Line	:	121 E REDD RD
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79932-1981
Country	:	US
Telephone Number	:	915-584-8882
Fax Number	:

Provider Business Practice Location Address
First Line	:	121 E REDD RD
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79932-1981
Country	:	US
Telephone Number	:	915-584-8882
Fax Number	:

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

Provider Enumeration Date	:	03/23/2006
Last Update Date	:	03/13/2008

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