MEDICARE: DR. CHARLES E GEYER JR. 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	207R00000X	Internal Medicine Physician	F6662	TX
2	207RH0003X	Hematology & Oncology Physician	0101254387	VA
3	207RX0202X	Medical Oncology Physician	MD419017	PA
4	207RH0003X	Hematology & Oncology Physician	F6662	TX

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
5	905763	OTHER	TX	MEDICARE NUMBER IND

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	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
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	:	1891795001
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHARLES E GEYER JR. MD

Provider Business Mailing Address
First Line	:	6445 MAIN ST FL 24
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77030-1502
Country	:	US
Telephone Number	:	713-441-9948
Fax Number	:	713-441-8791

Provider Business Practice Location Address
First Line	:	6445 MAIN ST FL 24
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77030-1502
Country	:	US
Telephone Number	:	713-441-9948
Fax Number	:	713-441-8791

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

Provider Enumeration Date	:	07/29/2005
Last Update Date	:	06/23/2020

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Directions to “ DR. CHARLES E GEYER JR. MD” Practice Location

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