MEDICARE: CHARLES T CLAYTON M.D.

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	2085R0202X	Diagnostic Radiology Physician	F1452	TX
2	2085R0203X	Therapeutic Radiology Physician	F1452	TX
3	2085R0204X	Vascular & Interventional Radiology Physician	F1452	TX
4	2085U0001X	Diagnostic Ultrasound Physician	F1452	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	F1452	OTHER	TX	LICENSE NUMBER

General Provider Information

NPI Number	:	1710082920
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHARLES T CLAYTON M.D.

Provider Business Mailing Address
First Line	:	1346 CAMPBELL RD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77055-6404
Country	:	US
Telephone Number	:	713-461-3399
Fax Number	:	713-461-1969

Provider Business Practice Location Address
First Line	:	1346 CAMPBELL RD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77055-6404
Country	:	US
Telephone Number	:	713-461-3399
Fax Number	:	713-461-1969

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

Provider Enumeration Date	:	09/13/2006
Last Update Date	:	09/11/2025

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