Individual
CARLA ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1750 NORTH HAMPTON ROAD, DESOTO, TX 75115
(214) 946-4397
(214) 946-4399
Mailing address
815 PENNSYLVANIA AVE, FORT WORTH, TX 76104-2224
(817) 321-0937
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
J8882
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
35943202
—
TX
01
—
81R914
DALLAS COUNTY PTAN
TX
Enumeration date
05/08/2006
Last updated
03/28/2016
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