Healthcare Provider Details

I. General information

NPI: 1023483658
Provider Name (Legal Business Name): CHARLES H SARGENT, MD PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/08/2015
Last Update Date: 02/15/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1010 CENTRAL PKWY S
SAN ANTONIO TX
78232-5021
US

IV. Provider business mailing address

1010 CENTRAL PKWY S
SAN ANTONIO TX
78232-5021
US

V. Phone/Fax

Practice location:
  • Phone: 210-255-1499
  • Fax: 210-255-1782
Mailing address:
  • Phone: 210-255-1499
  • Fax: 210-255-1782

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberH3342
License Number StateTX

VIII. Authorized Official

Name: CHARLES HUNT SARGENT
Title or Position: OWNER
Credential: MD, PA
Phone: 210-255-1499