Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | R7511 | TX |
N | 111NI0900X | Internist | R7511 | TX |
Y | 207RX0202X | Medical Oncology | R7511 | TX |
NPI | 1134419682 |
---|---|
Provider Name | Dr. Charles Vincent Kurkul |
First Address | Dallas, TX 75391-1230 |
Second Address | Denton, TX 76201-5148 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/04/2011 |
Last Update Date | 13/12/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
385611401 | (05) | TX |