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NPI Code Detail

MEDICARE: DR. CARRIE SIBLEY SHRADER DDS

MEDICARE: DR. CARRIE SIBLEY SHRADER DDS
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
1122300000XDentist12238TX

General Provider Information

NPI Number : 1447415708
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CARRIE SIBLEY SHRADER DDS
Provider Business Mailing Address
First Line : 701 COLLEGE AVE
Second Line :
City : SOUTH HOUSTON
State : TX
Zip : 77587-4205
Country : US
Telephone Number : 713-941-7555
Fax Number :
Provider Business Practice Location Address
First Line : 701 COLLEGE AVE
Second Line :
City : SOUTH HOUSTON
State : TX
Zip : 77587-4205
Country : US
Telephone Number : 713-941-7555
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/25/2008
Last Update Date : 07/25/2008

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Directions to “ DR. CARRIE SIBLEY SHRADER DDS” Practice Location

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