Individual
STEPHANIE H CARL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1720 S BECKHAM AVE STE 104, TYLER, TX 75701-4464
(903) 597-2002
Mailing address
PO BOX 846098, DALLAS, TX 75284-6098
(903) 324-6450
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
K4646
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
039150001
—
TX
05
—
039150002
—
TX
05
—
039150003
—
TX
01
—
123497
CHIPS
TX
01
—
75-2616977-136
TRICARE
TX
01
—
7781106
AETNA
TX
01
—
8178K0
BCBS OF TEXAS
TX
01
—
TIN PLUS 022
TRICARE CHAMPUS
TX
Enumeration date
02/10/2006
Last updated
07/21/2022
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