Carrol L Anderson Jr., M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

F6390 Issued in TX

Practice address

3302 Boca Chica Blvd Ste 109
Brownsville, TX 78521-4271

Phone

(956) 982-1001

Fax

(956) 982-1938

NPI assigned

Sep 26, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• C.L. Anderson, Jr., M.D., PLLC

  • Family Medicine Physician
  • Brownsville, TX
  • NPI 1396967659
  Medicare reassignment

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

{
    "created_epoch": "1159228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1483401600000",
    "number": "1457452922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3302 BOCA CHICA BLVD STE 109",
            "city": "BROWNSVILLE",
            "state": "TX",
            "postal_code": "785214271",
            "telephone_number": "956-982-1001",
            "fax_number": "956-982-1938"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3302 BOCA CHICA BLVD STE 109",
            "city": "BROWNSVILLE",
            "state": "TX",
            "postal_code": "785214271",
            "telephone_number": "956-982-1001",
            "fax_number": "956-982-1938"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "CARROL",
        "middle_name": "L",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-26",
        "last_updated": "2017-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "F6390",
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "TX",
            "license": "F6390",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID TEXAS HEALTH STEPS NUMBER",
            "identifier": "172803202",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "140145728",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID GROUP NUMBER",
            "identifier": "172803201",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP NUMBER",
            "identifier": "00345Y",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Anant K Utturkar
• Oscar David Anaya, LOY
• Anchor Primary Home Care LLC
• Ancira Family Dental
• Sandy Perez Andaverde, LPC-S
• Cristina Sosa Anderson, D.D.S.
• Guadalupe Andrade, RN
• Guadalupe Antonia Andrade, COTA
• Richard R Andrews, M.D.
• Anesethesia Specialists of Brownsville

• Family Medicine Physician in Brownsville, TX
• Providers in Brownsville, TX by specialty
• Family Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.