Individual
KARIS M MCCARROLL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD PA
Contact information
Practice address
16110 VIA SHAVANO, SAN ANTONIO, TX 78249-2380
(210) 615-7171
(210) 615-6793
Mailing address
16110 VIA SHAVANO, SAN ANTONIO, TX 78249-2380
(210) 615-7171
(210) 615-6793
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
G5032
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00B79C
BLUE CROSS BLUE SHIELD
TX
05
—
097574002
—
TX
01
—
1144291519
NPI
TX
01
—
240007915
RAILROAD MEDICARE NUMBER
TX
01
—
G5032
TEXAS LICENSE
TX
Enumeration date
02/01/2006
Last updated
08/11/2015
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