MEDICARE: CHARLES G HOLMSTEN MD AND ASSOCIATES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207QA0505X	Adult Medicine Physician	L8734	TX
2	207QA0505X	Adult Medicine Physician	D6035	TX
3	207QA0505X	Adult Medicine Physician	L8535	TX
4	207QA0505X	Adult Medicine Physician	K7677	TX
5	261QX0100X	Occupational Medicine Clinic/Center	D6035	TX
6	261QX0100X	Occupational Medicine Clinic/Center	L8734	TX
7	261QX0100X	Occupational Medicine Clinic/Center	L8535	TX
8	261QX0100X	Occupational Medicine Clinic/Center	K7677	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	108343	OTHER	TX	AMERIGROUP M E BUXBAUM,DO
2	57420H	OTHER	TX	BC BS GROUP NUMBER
3	8M5130	OTHER	TX	BC BS WALTER R HOLMSTEN
4	8F5610	OTHER	TX	BC BS M E BUXBAUM, DO
5	84V645	OTHER	TX	BC BS CHARLES G HOLMSTEN
6	25422	OTHER	TX	AMERIGROUP C G HOLMSTEN

General Provider Information

NPI Number	:	1043431521
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHARLES G HOLMSTEN MD AND ASSOCIATES

Provider Business Mailing Address
First Line	:	7545 S BRAESWOOD BLVD
Second Line	:	117 LANE DR TX 77471 AND 3122 SPENCER HWY TX 77504
City	:	HOUSTON
State	:	TX
Zip	:	77071-1423
Country	:	US
Telephone Number	:	713-777-3131
Fax Number	:	713-777-5544

Provider Business Practice Location Address
First Line	:	7545 S BRAESWOOD BLVD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77071-1423
Country	:	US
Telephone Number	:	713-777-3131
Fax Number	:	713-777-5544

Authorized Official
Title or Position	:	OWNER AND SEL PROPRIETOR
Name	:	DR. CHARLES G HOLMSTEN
Credential	:	MD
Telephone Number	:	713-777-3131

Provider Enumeration Date	:	05/01/2007
Last Update Date	:	09/11/2025

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