MEDICARE: MAKAYLEE CARTER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	TBD	TX

General Provider Information

NPI Number	:	1013616648
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MAKAYLEE CARTER

Provider Business Mailing Address
First Line	:	7703 FLOYD CURL DR
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78229-3901
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3209 COURTYARD DR STE D
Second Line	:
City	:	MIDLAND
State	:	TX
Zip	:	79705-3276
Country	:	US
Telephone Number	:	432-218-4389
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/02/2023
Last Update Date	:	06/02/2026

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Directions to “ MAKAYLEE CARTER ” Practice Location

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