Individual
BRIAN B CARPENTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
855 MONTGOMERY ST, FORT WORTH, TX 76107-2553
(817) 735-2900
Mailing address
PO BOX 99335, FORT WORTH, TX 76199-0335
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
1305
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
121590705
—
TX
05
—
121590707
—
TX
01
—
8CP001
BCBS
TX
01
—
8K7413
BCBS
TX
01
—
P00281279
RAILROAD MEDICARE
TX
01
—
P00936117
RAILROAD MEDICARE
TX
Enumeration date
04/19/2006
Last updated
01/18/2012
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