MEDICARE: MISS CAROLYN RENEE CAUDELL MPT

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	1176720	TX

General Provider Information

NPI Number	:	1891981486
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS CAROLYN RENEE CAUDELL MPT

Provider Business Mailing Address
First Line	:	6521 COLLIN MCKINNEY PKWY
Second Line	:
City	:	MCKINNEY
State	:	TX
Zip	:	75070-2726
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6521 COLLIN MCKINNEY PKWY
Second Line	:
City	:	MCKINNEY
State	:	TX
Zip	:	75070-2726
Country	:	US
Telephone Number	:	936-554-2762
Fax Number	:

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

Provider Enumeration Date	:	09/18/2007
Last Update Date	:	12/03/2024

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