Provider Demographics
NPI:1750704706
Name:CARTER, CARLA R (CRNA)
Entity type:Individual
Prefix:
First Name:CARLA
Middle Name:R
Last Name:CARTER
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:CARLA
Other - Middle Name:R
Other - Last Name:FOSTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNA
Mailing Address - Street 1:8028 SAINT LOUIS ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77028-4556
Mailing Address - Country:US
Mailing Address - Phone:281-989-6218
Mailing Address - Fax:
Practice Address - Street 1:8028 SAINT LOUIS ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77028-4556
Practice Address - Country:US
Practice Address - Phone:281-989-6218
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-28
Last Update Date:2019-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX092678367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered