DR. TED L CARELOCK M.D. NPI 1972502367

NPI Information

NPI: 1972502367
Provider Name: DR. TED L CARELOCK, M.D.
Classification: Radiology - 2085R0202X
Entity Type: Individual

Specialization: Diagnostic Radiology

Address:
815 PENNSYLVANIA AVE
FORT WORTH, TX
ZIP 76104
Phone: (817) 321-0312
Get Directions

DR. Ted L Carelock, M.D. is a diagnostic radiology radiology in Fort Worth, TX. The provider is a radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. DR. Ted L Carelock, M.D. NPI is 1972502367. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

815 PENNSYLVANIA AVE
FORT WORTH, TX
ZIP 76104-224
Phone: (817) 321-0312
Fax: (817) 317-7033

The enumeration date for this NPI number is 7/18/2005 and was last updated on 8/15/2012.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	2085B0100X	Radiology	Body Imaging	D3992	TEXAS	No
2	2085U0001X	Radiology	Diagnostic Ultrasound	D3992	TEXAS	No
3	2085R0202X	Radiology	Diagnostic Radiology	D3992	TEXAS	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	1341299-11	MEDICAID	TEXAS
2	TXB120535	MEDICARE PIN	TEXAS
3	85R583	MEDICARE ID-TYPE UNSPECIFIED	TEXAS	DALLAS COUNTY
4	89361R	MEDICARE ID-TYPE UNSPECIFIED	TEXAS	'OTHER' COUNTIES
5	B21695	MEDICARE UPIN	TEXAS
6	134129909	MEDICAID	TEXAS
7	134129906	MEDICAID	TEXAS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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