MEDICARE: CHARLES WARREN

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	111N00000X	Chiropractor	14885	TX

General Provider Information

NPI Number	:	1548917388
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHARLES WARREN

Provider Business Mailing Address
First Line	:	271 SAWDUST RD
Second Line	:
City	:	SPRING
State	:	TX
Zip	:	77380-2238
Country	:	US
Telephone Number	:	832-381-8889
Fax Number	:

Provider Business Practice Location Address
First Line	:	271 SAWDUST RD
Second Line	:
City	:	SPRING
State	:	TX
Zip	:	77380-2238
Country	:	US
Telephone Number	:	832-381-8889
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/02/2022
Last Update Date	:	12/11/2022

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Directions to “ CHARLES WARREN ” Practice Location

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