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NPI Code Detail

MEDICARE: CAROL KRETCHMAR

MEDICARE: CAROL KRETCHMAR
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
1235Z00000XSpeech-Language Pathologist19523TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1437283033
Entity Type Code : Individual
Provider Name (Legal Business Name) : CAROL KRETCHMAR
Provider Business Mailing Address
First Line : 2622 HIGHVIEW TER
Second Line :
City : FORT WORTH
State : TX
Zip : 76109-1038
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 508 S ADAMS ST
Second Line : SUITE 102
City : FORT WORTH
State : TX
Zip : 76104-2147
Country : US
Telephone Number : 817-878-2834
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/15/2007
Last Update Date : 07/08/2007

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Directions to “ CAROL KRETCHMAR ” Practice Location

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