Healthcare Provider Details

I. General information

NPI: 1003922931
Provider Name (Legal Business Name): CARL EDWARD NOE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/22/2006
Last Update Date: 08/20/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1801 INWOOD RD OUTPATIENT BUILDING WA 7.5
DALLAS TX
75390-9189
US

IV. Provider business mailing address

1801 INWOOD RD OUTPATIENT BUILDING WA 7.5
DALLAS TX
75235-7202
US

V. Phone/Fax

Practice location:
  • Phone: 214-645-8450
  • Fax: 214-645-8451
Mailing address:
  • Phone: 214-645-8450
  • Fax: 214-645-8451

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License NumberG8318
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberD8318
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License NumberG8318
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: