Healthcare Provider Details

I. General information

NPI: 1811988892
Provider Name (Legal Business Name): CHARLES C. TRINH M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/31/2005
Last Update Date: 06/27/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

BAYLOR COLLEGE OF MEDICINE ONE BAYLOR PLAZA MS-360
HOUSTON TX
77030
US

IV. Provider business mailing address

BAYLOR COLLEGE OF MEDICINE ONE BAYLOR PLAZA MS-360
HOUSTON TX
77030
US

V. Phone/Fax

Practice location:
  • Phone: 713-798-4417
  • Fax: 713-798-8050
Mailing address:
  • Phone: 713-798-4417
  • Fax: 713-798-8050

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberJ8806
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: