Basic Information
Provider Information
NPI: 1093266116
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MCCAFFREY
FirstName: CARLY
MiddleName: RIHN
NamePrefix:  
NameSuffix:  
Credential: AG-ACNP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 6720 BERTNER AVE
Address2:  
City: HOUSTON
State: TX
PostalCode: 770302604
CountryCode: US
TelephoneNumber: 8323552666
FaxNumber:  
Practice Location
Address1: 6720 BERTNER AVE
Address2:  
City: HOUSTON
State: TX
PostalCode: 770302604
CountryCode: US
TelephoneNumber: 8323552666
FaxNumber:  
Other Information
ProviderEnumerationDate: 10/24/2016
LastUpdateDate: 01/25/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 01/25/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LC0200X769887TXY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerCritical Care Medicine

No ID Information.


Home