Healthcare Provider Details

I. General information

NPI: 1619172202
Provider Name (Legal Business Name): VICKI LAKWANDA CARR MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/15/2007
Last Update Date: 07/11/2025
Certification Date: 07/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20311 KUYKENDAHL RD.
SPRING TX
77379-2614
US

IV. Provider business mailing address

25214 FLEMING MEADOW
SPRING TX
77389
US

V. Phone/Fax

Practice location:
  • Phone: 832-717-3376
  • Fax: 832-717-0004
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207NP0225X
TaxonomyPediatric Dermatology Physician
License NumberBP2-0018536
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: