MEDICARE: DR. CHARLOTTE THERESA STARGHILL MD

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	207Q00000X	Family Medicine Physician	J2354	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	OO30GX	OTHER	TX	BLUE CROSS BLUE SHIELD
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1770582322
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHARLOTTE THERESA STARGHILL MD

Provider Business Mailing Address
First Line	:	PO BOX 226403
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75222-6403
Country	:	US
Telephone Number	:	972-283-1951
Fax Number	:	972-283-1988

Provider Business Practice Location Address
First Line	:	7010 AMERICAN WAY
Second Line	:	SUITE D
City	:	DALLAS
State	:	TX
Zip	:	75237-2499
Country	:	US
Telephone Number	:	972-283-1951
Fax Number	:	972-283-1988

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

Provider Enumeration Date	:	07/16/2005
Last Update Date	:	07/09/2007

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Directions to “ DR. CHARLOTTE THERESA STARGHILL MD” Practice Location

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