Individual
CARIS SUPERVILLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGPCNP
Contact information
Practice address
7610 W HIGHWAY 71, SUITE F, AUSTIN, TX 78735-8231
(512) 288-0859
Mailing address
3967 FERNANDO DR, EULESS, TX 76040-3448
(940) 632-6843
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
AP127762
TX
Other
Enumeration date
05/18/2015
Last updated
05/18/2015
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