Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RX0202X | Medical Oncology | F4804 | TX |
NPI | 1114969219 |
---|---|
Provider Name | Dr. Charles Jay Deur |
First Address | Dallas, TX 75391-1230 |
Second Address | Arlington, TX 76012-2616 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/06/2006 |
Last Update Date | 09/05/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
131943601 | (05) | TX |
131943602 | (05) | TX |
131943604 | (05) | TX |
131943605 | CSHCN (01) | TX |
131943607 | (05) | TX |
8R1426 | BLUE CROSS OF TEXAS (01) | TX |
B22232 | (02) |