Individual
MR. BRETT WARD CARPENTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.T.
Contact information
Practice address
3126 APPALOOSA CIR, SAN ANGELO, TX 76901-5225
(325) 944-4399
(325) 944-4556
Mailing address
3126 APPALOOSA CIR, SAN ANGELO, TX 76901-5225
(325) 944-4399
(325) 944-4556
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1090462
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
059100002
—
TX
01
—
86884T
BLUE CROSS BLUE SHIELD
TX
Enumeration date
05/09/2006
Last updated
04/29/2013
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