Healthcare Provider Details

I. General information

NPI: 1164568283
Provider Name (Legal Business Name): CHARLES THOMAS SWEET M.D., M.P.H.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/29/2007
Last Update Date: 02/12/2024
Certification Date: 01/26/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2217 PARK BEND DR STE 300
AUSTIN TX
78758-5674
US

IV. Provider business mailing address

2217 PARK BEND DR STE 300
AUSTIN TX
78758-5674
US

V. Phone/Fax

Practice location:
  • Phone: 512-382-1933
  • Fax: 512-778-8000
Mailing address:
  • Phone: 512-382-1933
  • Fax: 512-778-8000

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberC172258
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License NumberN1170
License Number StateTX
# 3
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberN1170
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: