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General NPI Number Information
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NPI Number | 1114969219
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Entity Type | Individual
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Provider Name | CHARLES JAY DEUR M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/12/2006
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Last Update Date | 05/09/2016
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Provider Practice Location Address
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Address Line | 801 ROAD TO SIX FLAGS W SUITE 105
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City | ARLINGTON
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State | TX
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Zip | 76012-2616
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Country | US
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Telephone | 817-274-6532
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Fax | 817-548-8744
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Provider Business Mailing Address
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Address Line | PO BOX 911230
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City | DALLAS
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State | TX
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Zip | 75391-1230
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Country | US
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Telephone | 972-997-8000
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Fax | 972-437-9605
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RX0202X
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Taxonomy Name | Medical Oncology Physician
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License Number | F4804
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License Number State | TX
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