MEDICARE: MS. DONNA JEAN CARVER PT

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	225100000X	Physical Therapist	1121150	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	8KU591	OTHER	TX	BCBS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1528045515
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. DONNA JEAN CARVER PT

Provider Business Mailing Address
First Line	:	404 E DENTON DR
Second Line	:
City	:	EULESS
State	:	TX
Zip	:	76039-3929
Country	:	US
Telephone Number	:	817-233-8350
Fax Number	:

Provider Business Practice Location Address
First Line	:	1402 N CORINTH ST STE 117
Second Line	:
City	:	CORINTH
State	:	TX
Zip	:	76208-5445
Country	:	US
Telephone Number	:	817-233-8350
Fax Number	:

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

Provider Enumeration Date	:	12/29/2005
Last Update Date	:	07/21/2020

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Directions to “ MS. DONNA JEAN CARVER PT” Practice Location

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