Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204F00000X | Transplant Surgeon | E8213 | TX |
N | 208200000X | Surgeon | E8213 | TX |
N | 208600000X | Surgeon | E8213 | TX |
NPI | 1821013210 |
---|---|
Provider Name | Dr. Charles T Vanburen |
First Address | Houston, TX 77005-3743 |
Second Address | Houston, TX 77005-3743 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/07/2006 |
Last Update Date | 20/06/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
135982001 | CSHCN (01) | TX |
135982005 | (05) | TX |
88Y755 | BCBS (01) | TX |
C22900 | (02) | TX |