MEDICARE: CARA ELAINE CHARANZA MED, LMFT

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	106H00000X	Marriage & Family Therapist	205369	TX

General Provider Information

NPI Number	:	1477324812
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CARA ELAINE CHARANZA MED, LMFT

Provider Business Mailing Address
First Line	:	117 ROYAL ST STE 101
Second Line	:
City	:	BRYAN
State	:	TX
Zip	:	77801-4432
Country	:	US
Telephone Number	:	979-205-0030
Fax Number	:

Provider Business Practice Location Address
First Line	:	117 ROYAL ST STE 101
Second Line	:
City	:	BRYAN
State	:	TX
Zip	:	77801-4432
Country	:	US
Telephone Number	:	979-205-0030
Fax Number	:

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

Provider Enumeration Date	:	01/15/2024
Last Update Date	:	03/18/2026

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