Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223G0001X | General Practice | 15824 | TX |
Y | 213EG0000X | General Practice | 15824 | TX |
NPI | 1003811308 |
---|---|
Provider Name | Dr. Charles Michael Sauter |
First Address | Mesquite, TX 75149-1365 |
Second Address | Mesquite, TX 75149-1365 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/06/2005 |
Last Update Date | 09/07/2007 |