Individual ProviderCarl Thomas LongInternal MedicineAllopathic & Osteopathic PhysiciansPractice Address4708 Alliance Blvd Ste 300, Baylor Medical Plaza 1, Plano, TX 75093-5339(972) 758-6000PECOS EnrollmentBased on the most recent information from CMS, provider Carl Thomas Long does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 5 days ago.Profile DetailsProvider ID1306951215Provider TypeIndividualFull NameLong, Carl ThomasTitleDr.CredentialM.D.GenderMaleSole ProprietorNoEnumeration Date8/20/2006Last Updated7/15/2008Contact InformationPractice LocationPractice Address4708 Alliance Blvd Ste 300, Baylor Medical Plaza 1, Plano, TX 75093-5339Phone(972) 758-6000Fax(972) 758-6001Mailing LocationMailing Address4708 Alliance Blvd Ste 300, Baylor Medical Plaza 1, Plano, TX 75093-5339Phone(972) 758-6000Fax(972) 758-6001Provider TaxonomiesCodeDescriptionLicenseCode207R00000XPrimaryDescriptionInternal MedicineAllopathic & Osteopathic PhysiciansLicenseE2682TexasProvider IdentifiersIDDescriptionIssuerID1145435-04DescriptionMedicaidIssuerUnlistedTexasID83X007DescriptionOtherIssuerBCBSTexas