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Tabitha Joana Faith Carolina

Family Medicine

Allopathic & Osteopathic Physicians

1102 Barclay St, San Antonio, TX 78207-7161

PECOS Enrollment

This provider is enrolled in PECOS as TABITHA CAROLINA.

Based on the most recent information from CMS, provider Tabitha Joana Faith Carolina is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 2 days ago.

Profile Details

Provider ID
1184207045
Provider Type
Individual
Full Name
Carolina, Tabitha Joana Faith
Credential
DO

Gender
Female
Sole Proprietor
No
Enumeration Date
4/29/2021
Last Updated
3/2/2023

Contact Information

Practice Location

1102 Barclay St, San Antonio, TX 78207-7161

(210) 283-6304

Unlisted Fax

Mailing Location

13515 West Ave Apt 1023, San Antonio, TX 78216-2088

(405) 204-3382

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 207Q00000X Primary	Description Family Medicine Allopathic & Osteopathic Physicians	License U0562 Texas

Tabitha Joana Faith Carolina

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

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