Individual
CAROL A ADDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
945 TROPHY CLUB DR, TROPHY CLUB, TX 76262-5580
(817) 430-9111
(817) 430-8911
Mailing address
945 TROPHY CLUB DR, TROPHY CLUB, TX 76262-5580
(817) 430-9111
(817) 430-8911
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA00527
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PA00527
TEXAS MEDICAL BOARD LICEN
TX
01
—
R0131625
TEXAS DPS
TX
Enumeration date
03/08/2007
Last updated
03/07/2023
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