Individual
DR. BRIAN KEITH CARREON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1502 12TH ST, SUITE A, SHALLOWATER, TX 79363-5652
(806) 832-4566
(806) 832-4143
Mailing address
PO BOX 2088, SHALLOWATER, TX 79363-2088
(806) 832-4566
(806) 832-4143
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
L9125
TX
207Q00000X
Family Medicine Physician
Primary
L9125
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
168484708
—
TX
05
—
168484709
—
TX
Enumeration date
02/08/2006
Last updated
01/14/2021
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