Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QA0505X | Family Doctor - Adult Medicine | D6035 | TX |
NPI | 1083728711 |
---|---|
Provider Name | Mr. Charles G Holmsten |
First Address | Houston, TX 77096 |
Second Address | Houston, TX 77096 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/08/2006 |
Last Update Date | 28/01/2022 |