Provider Demographics
NPI:1871930388
Name:CARPENTER, KACY NICOLE (DO)
Entity type:Individual
Prefix:DR
First Name:KACY
Middle Name:NICOLE
Last Name:CARPENTER
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2850 LEWIS LN
Mailing Address - Street 2:STE 101
Mailing Address - City:PARIS
Mailing Address - State:TX
Mailing Address - Zip Code:75460-9383
Mailing Address - Country:US
Mailing Address - Phone:903-784-0800
Mailing Address - Fax:903-784-0866
Practice Address - Street 1:2850 LEWIS LN
Practice Address - Street 2:STE 101
Practice Address - City:PARIS
Practice Address - State:TX
Practice Address - Zip Code:75460-9383
Practice Address - Country:US
Practice Address - Phone:903-784-0800
Practice Address - Fax:903-784-0866
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-24
Last Update Date:2019-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXR0200207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology