Healthcare Provider Details

I. General information

NPI: 1174861652
Provider Name (Legal Business Name): RONNIE D CARTER DVM
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/17/2013
Last Update Date: 01/17/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

370 STATE HIGHWAY 110
GRAND SALINE TX
75140-5104
US

IV. Provider business mailing address

PO BOX 399
GRAND SALINE TX
75140-0399
US

V. Phone/Fax

Practice location:
  • Phone: 903-962-4296
  • Fax: 903-962-4298
Mailing address:
  • Phone: 903-962-4296
  • Fax: 903-962-4298

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174M00000X
TaxonomyVeterinarian
License Number3553
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: