Individual
CAROLYN LEE STANFORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
14902 CROSSCREEK, AUSTIN, TX 78737-8904
(512) 647-9883
(512) 647-9883
Mailing address
6705 W HIGHWAY 290 STE 502, AUSTIN, TX 78735-8407
(512) 647-9883
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
AP110163
TX
Other
Enumeration date
09/06/2020
Last updated
09/06/2020
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