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General NPI Number Information
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NPI Number | 1902887755
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Entity Type | Individual
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Provider Name | CAROLYN BARKER MCDOUGALD D.O.
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Gender | Female
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Dates
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Enumeration Date | 11/09/2005
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Last Update Date | 07/01/2021
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Provider Practice Location Address
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Address Line | 3401 N UNIVERSITY AVE
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City | LUBBOCK
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State | TX
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Zip | 79415-1734
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Country | US
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Telephone | 806-763-7041
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Fax |
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Provider Business Mailing Address
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Address Line | 4621 S COOPER ST STE 131-245
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City | ARLINGTON
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State | TX
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Zip | 76017-5866
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Country | US
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Telephone | 832-266-3554
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Fax |
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | L2458
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License Number State | TX
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