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General NPI Number Information
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NPI Number | 1952796732
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Entity Type | Organization
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Legal Business Name | BOBBY G. CARTER
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Dates
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Enumeration Date | 03/30/2015
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Last Update Date | 03/30/2015
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Provider Practice Location Address
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Address Line | 3809 22ND ST STE 2-D
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City | LUBBOCK
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State | TX
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Zip | 79410-1198
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Country | US
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Telephone | 806-773-0192
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Fax |
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Provider Business Mailing Address
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Address Line | 3229 92ND ST
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City | LUBBOCK
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State | TX
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Zip | 79423-3712
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Country | US
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Telephone | 806-773-0192
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Fax |
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Authorized Official
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Title or Position | LPC
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Name | MR. BOBBY GLEN CARTER
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Credential | LPC
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Telephone | 806-773-0192
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 70548
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License Number State | TX
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