Individual provider Active NPI

Carolyn Barker McDougald, D.O.

  • Family Medicine Physician
  • Lubbock, TX
National Provider Identifier
1902887755
Registry record updated Jul 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
L2458 Issued in TX
Practice address
3401 N University Ave
Lubbock, TX 79415-1734
Phone
(806) 763-7041
NPI assigned
Nov 9, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 1, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X L2458 TX Primary

Addresses

Primary practice location

3401 N University Ave
Lubbock, TX 79415-1734

Mailing address

4621 S Cooper St Ste 131-245
Arlington, TX 76017-5866
Phone (832) 266-3554

Other practice location 1

9903 Kemp Forest Dr
Houston, TX 77080
Phone (682) 305-1250

Other identifiers 1

IdentifierTypeStateIssuer
169246901MedicaidTX

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20040612000062 TX Practitioner - Family PracticePractitioner - Emergency Medicine 6305829003 Reassigns benefits to 6 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy, Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Jackson County Hospital District Emergency Medicine CurrentSince Nov 6, 2012 Accepting new patients
Jackson County Hospital District CurrentSince Nov 6, 2012 Accepting new patients
Choctaw Nation of Oklahoma Current Accepting new patients
Frio Hospital Association Emergency Medicine CurrentSince Jan 30, 2014 Accepting new patients
Muenster Hospital District Emergency Medicine CurrentSince Jan 23, 2014 Accepting new patients
Health and Human Services Commission Family Medicine CurrentSince Mar 12, 2020 Accepting new patients
Choctaw Nation of Oklahoma CurrentSince Feb 21, 2020 Accepting new patients
Muenster Hospital District Family Medicine CurrentSince Jan 23, 2014 Accepting new patients
Health and Human Services Commission CurrentSince Mar 12, 2020 Accepting new patients
Choctaw Nation of Oklahoma CurrentSince Feb 21, 2020 Accepting new patients
Frio Hospital Association CurrentSince Jan 30, 2014 Accepting new patients
Dewitt Medical District Emergency Medicine CurrentSince Mar 8, 2013 Accepting new patients
Dewitt Medical District CurrentSince Mar 8, 2013 Accepting new patients
Health and Human Services Commission Current Accepting new patients
Twin Fountains Urgent Care Center Past Accepting new patients
Family Geriatrics PA Past Accepting new patients

Locations

1585 W Liberty Rd
Atoka, OK 74525
Phone (580) 889-1981

1300 E Martin Luther King Dr
Broken Bow, OK 74728
Phone (580) 208-2204

410 N M St
Hugo, OK 74743
Phone (580) 326-7561

902 E Lincoln Rd
Idabel, OK 74745
Phone (580) 286-2600

1127 S George Nigh Expy
McAlester, OK 74501
Phone (800) 349-7026

109 Kerr Blvd
Poteau, OK 74953
Phone (918) 649-1100

2204 E Main St
Stigler, OK 74462
Phone (918) 967-9200

205 Dallas St
Talihina, OK 74571
Phone (918) 567-3636

1 Choctaw Way
Talihina, OK 74571
Phone (918) 423-8440

2501 Maple St
Abilene, TX 79602
Phone (325) 692-4053

4001 Highway 36 S
Brenham, TX 77833
Phone (979) 277-1327

2550 N Esplanade St
Cuero, TX 77954
Phone (361) 275-0532

1013 S Wells St
Edna, TX 77957
Phone (361) 782-5241

113 W Main St
Kenedy, TX 78119
Phone (830) 583-0612

3401 N University Ave
Lubbock, TX 79415
Phone (806) 741-3514

605 N Maple St
Muenster, TX 76252
Phone (940) 759-2271

151 Medical Dr
Pearsall, TX 78061
Phone (830) 334-4126

Organizations & group practices 16

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.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1131494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625097600000",
    "number": "1902887755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4621 S COOPER ST STE 131-245",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760175866",
            "telephone_number": "832-266-3554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3401 N UNIVERSITY AVE",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794151734",
            "telephone_number": "806-763-7041"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9903 Kemp Forest Dr",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "77080",
            "country_code": "US",
            "telephone_number": "682-305-1250",
            "fax_number": "866-388-2989",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCDOUGALD",
        "first_name": "CAROLYN",
        "middle_name": "BARKER",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-11-09",
        "last_updated": "2021-07-01",
        "certification_date": "2021-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "L2458",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "169246901",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lubbock, TX

Sources for this page

Verify at the official NPI Registry.