Angelique Blair Carmouche, MAT, LAT,ATC

Primary specialty

Sports Medicine (Preventive Medicine) PhysicianTaxonomy code 2083S0010X

License

AT8258 Issued in TX

Practice address

Asu Station #10899
San Angelo, TX 76909-0001

Phone

(940) 435-4347

NPI assigned

Jun 28, 2019

Last updated

Jan 25, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1561680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611532800000",
    "number": "1396307476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "LSU ATHLETIC ADMINISTRATION BUILDING",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708030001",
            "telephone_number": "225-578-8001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "ASU STATION #10899",
            "city": "SAN ANGELO",
            "state": "TX",
            "postal_code": "769090001",
            "telephone_number": "940-435-4347"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Lsu Athletic Administration Building",
            "address_purpose": "LOCATION",
            "city": "Baton Rouge",
            "state": "LA",
            "postal_code": "708030001",
            "country_code": "US",
            "telephone_number": "225-578-8001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CARMOUCHE",
        "first_name": "ANGELIQUE",
        "middle_name": "BLAIR",
        "credential": "MAT, LAT,ATC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-28",
        "last_updated": "2021-01-25",
        "certification_date": "2021-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2083S0010X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Sports Medicine",
            "state": "LA",
            "license": "319966",
            "primary": false
        },
        {
            "code": "2083S0010X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Sports Medicine",
            "state": "TX",
            "license": "AT8258",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John S Cargile III, MD
• Maegin M Carlile, FNP
• Lee K Carlisle, APRN, BC, FNP
• Riley Carlyle, RBT
• Ross Carmichael, MD
• Kristin Nicole Carney, LPC
• Brett Ward Carpenter, P.T.
• Tiffany Jackson Carpenter, O.T.R.
• Michael F Carper
• Joel L. Carr, PH.D., LCSW-S, LPC-S

• Sports Medicine (Preventive Medicine) Physician in San Angelo, TX
• Providers in San Angelo, TX by specialty
• Sports Medicine (Preventive Medicine) Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.