Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0203X | Pediatric Critical Care Doctor | P6151 | TX |
NPI | 1306118013 |
---|---|
Provider Name | Dr. Corey Chartan |
First Address | Houston, TX 77070 |
Second Address | Houston, TX 77070 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/01/2012 |
Last Update Date | 28/06/2013 |