=====================================================
General NPI Number Information
=====================================================
NPI Number | 1497393870
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | CARMEN DANIELLE DOERR-NAUTH DC
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/16/2019
-----------------------------------------------------
Last Update Date | 04/23/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 23221 RED RIVER DR
-----------------------------------------------------
City | KATY
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77494-2031
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 713-487-9755
-----------------------------------------------------
Fax | 346-388-3263
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 20927 WESTFIELD TERRACE TRL
-----------------------------------------------------
City | KATY
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77449-2166
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 727-204-8471
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 111N00000X
-----------------------------------------------------
Taxonomy Name | Chiropractor
-----------------------------------------------------
License Number | CH13011
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 111N00000X
-----------------------------------------------------
Taxonomy Name | Chiropractor
-----------------------------------------------------
License Number | 14186
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------