Basic Information
| Provider Information | |||||||||
| NPI: | 1346230224 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | FELTON | ||||||||
| FirstName: | CAROL | ||||||||
| MiddleName: | KK | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3601 4TH ST FL 3 | ||||||||
| Address2: | |||||||||
| City: | LUBBOCK | ||||||||
| State: | TX | ||||||||
| PostalCode: | 794308340 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8067432340 | ||||||||
| FaxNumber: | 8067433121 | ||||||||
| Practice Location | |||||||||
| Address1: | 3601 4TH ST FL 3 | ||||||||
| Address2: | |||||||||
| City: | LUBBOCK | ||||||||
| State: | TX | ||||||||
| PostalCode: | 794300002 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8067432340 | ||||||||
| FaxNumber: | 8067433121 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/24/2005 | ||||||||
| LastUpdateDate: | 03/31/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 03/31/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207V00000X | G8696 | TX | Y | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |
ID Information
| ID | Type | State | Issuer | Description | 83026Z | 01 | TX | HMO BLUE | OTHER | 52403 | 05 | NM | MEDICAID | A002 | 01 | NM | TRIWEST | OTHER | 115015302 | 05 | TX | MEDICAID | 112596102 | 05 | TX | MEDICAID | 89522G | 01 | TX | BC/BS | OTHER | 52403 | 01 | NM | PRESBYTERIAN COMMERCIAL | OTHER | 100025190A | 05 | OK | MEDICAID | 112596101 | 01 | TX | FIRSTCARE COMMERCIAL | OTHER | 115015301 | 05 | TX | MEDICAID | T9575 | 05 | NM | MEDICAID |