Carolyn Jill Vandiver, MD
Radiology, Diagnostic Radiology in Desoto, TX. Individual provider (NPI-1).
NPI number1790733475
StatusActive
Last updated in NPPESMar 11, 2013
Details
- NPI
- 1790733475
- Entity type
- Individual (NPI-1)
- Name
- Carolyn Jill Vandiver
- Credential
- MD
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- May 4, 2006
- Last updated
- Mar 11, 2013
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2085R0202X | Radiology, Diagnostic Radiology | K8548 | TX | Yes |
Practice location
1750 North Hampton RoadDesoto, TX 75115-2306
Phone 214-946-4397 · Fax 214-946-4399
Mailing address
1750 North Hampton RoadDesoto, TX 75115-2306
Phone 214-946-4397 · Fax 214-946-4399
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