MEDICARE: DR. TRENTON ANDREW CARLYLE M.D.

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	207X00000X	Orthopaedic Surgery Physician	L1285	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P01085058	OTHER	TX	RAILROAD
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1093711038
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TRENTON ANDREW CARLYLE M.D.

Provider Business Mailing Address
First Line	:	PO BOX 5730
Second Line	:
City	:	BELFAST
State	:	ME
Zip	:	04915-5700
Country	:	US
Telephone Number	:	888-402-7256
Fax Number	:

Provider Business Practice Location Address
First Line	:	23530 KINGSLAND BLVD STE 302
Second Line	:
City	:	KATY
State	:	TX
Zip	:	77494-7466
Country	:	US
Telephone Number	:	281-733-2863
Fax Number	:	713-965-7633

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

Provider Enumeration Date	:	06/23/2005
Last Update Date	:	09/22/2021

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Directions to “ DR. TRENTON ANDREW CARLYLE M.D.” Practice Location

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