Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207QG0300X | Family Doctor - Geriatric Medicine | C5622 | TX |
N | 207R00000X | Internist | C5622 | TX |
N | 111NI0900X | Internist | C5622 | TX |
NPI | 1043224066 |
---|---|
Provider Name | Dr. Charles R Cain |
First Address | Dallas, TX 75243-8264 |
Second Address | Dallas, TX 75243-8264 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/07/2006 |
Last Update Date | 09/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
C14068 | (02) | TX |