Individual
MRS. CAROL JEAN NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
100 MUNICIPAL DR, GUN BARREL CITY, TX 75156-3702
(903) 713-1511
(903) 713-1519
Mailing address
344 NW CR 2171, BARRY, TX 75102
(903) 229-7367
Taxonomy
Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
PA02477
TX
363A00000X
Physician Assistant
Primary
PA02477
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
133367605
—
TX
Enumeration date
10/02/2006
Last updated
10/24/2019
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