Charles Thomas Black
Pediatric Surgery
12200 Park Central Dr Ste 400
Dallas
, Texas 75251-2116
Charles Thomas Black
Pediatric Surgery
12200 Park Central Dr Ste 400
Dallas
, Texas 75251-2116
(214) 483-9301
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About
Features
Specialties
- Pediatric Surgery
Languages spoken
- English
Location
First Address
- Charles Thomas Black
- 12200 Park Central Dr Ste 400
- Dallas, TX
- Zip : 75251-2116
- Fax : (214) 483-9301
- Phone : (214) 483-9300
Second Address
- Charles Thomas Black
- 12200 Park Central Dr Ste 400
- Dallas, TX
- Zip : 75251-2116
- Fax : (214) 483-9301
- Phone : (214) 483-9300
Reviews
FAQs
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What type of doctor is Charles Thomas Black
In what state does Charles Thomas Black practice in?
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 2086S0120X | Pediatric Surgery | F3761 | TX |
National Provider Identifier
| NPI | 1528049723 |
|---|---|
| Provider Name | Charles Thomas Black |
| First Address | Dallas, TX 75251-2116 |
| Second Address | Dallas, TX 75251-2116 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 07/11/2005 |
| Last Update Date | 13/05/2020 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 0134405 | UNITED HEALTH CARE (01) | TX |
| 10009560 | AMERIGROUP (01) | TX |
| 127631 | SUPERIOR CHIP (01) | TX |
| 138311911 | (05) | TX |
| 138311913 | (05) | TX |
| 138311914 | CSHCN (01) | TX |
| 153410004 | PACIFICARE (01) | TX |
| 3725428015 | CIGNA (01) | TX |
| 389962 | ONE HEALTH PLAN (01) | TX |
| 4130343 | AETNA (01) | TX |
| 41814 | AETNA MEDICAID (01) | TX |
| 80390N | BLUE CROSS (01) | |
| 8F23627 | (02) | TX |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.