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General NPI Number Information
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NPI Number | 1316978703
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Entity Type | Individual
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Provider Name | BRIAN D. CARR CP
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Gender | Male
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Dates
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Enumeration Date | 07/05/2006
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Last Update Date | 08/12/2008
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Provider Practice Location Address
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Address Line | 3709 22ND PL SUITE C
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City | LUBBOCK
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State | TX
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Zip | 79410-1333
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Country | US
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Telephone | 806-795-3911
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Fax | 806-795-2315
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Provider Business Mailing Address
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Address Line | 3709-22ND PLACE SUITE C
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City | LUBBOCK
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State | TX
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Zip | 79410
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Country | US
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Telephone | 806-795-3911
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Fax | 806-795-2315
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 23763
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License Number State | TX
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