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General NPI Number Information
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NPI Number | 1144544149
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Entity Type | Organization
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Legal Business Name | CHARLES B SHUEY JR MD PA
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Dates
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Enumeration Date | 03/19/2010
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Last Update Date | 11/27/2011
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Provider Practice Location Address
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Address Line | 3600 GASTON AVE SUITE 210
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City | DALLAS
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State | TX
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Zip | 75246-1800
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Country | US
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Telephone | 214-796-3439
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Fax | 877-720-0539
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Provider Business Mailing Address
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Address Line | 3701 JUNIUS ST # B010
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City | DALLAS
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State | TX
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Zip | 75246-2026
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Country | US
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Telephone | 214-796-3439
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Fax | 877-720-0539
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. CHARLES B. SHUEY
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Credential | M.D.
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Telephone | 214-384-3734
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number | C9136
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License Number State | TX
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