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General NPI Number Information
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NPI Number | 1255819058
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Entity Type | Individual
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Provider Name | ANGELIA N/A CHARLES
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Gender | Female
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Dates
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Enumeration Date | 08/02/2018
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Last Update Date | 08/02/2018
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Provider Practice Location Address
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Address Line | 5631 TUSKEGEE ST
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City | HOUSTON
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State | TX
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Zip | 77091-4120
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Country | US
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Telephone | 713-657-9084
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Fax |
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Provider Business Mailing Address
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Address Line | 9597 JONES RD # 117
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City | HOUSTON
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State | TX
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Zip | 77065-4815
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Country | US
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Telephone | 713-657-9084
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Fax |
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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 | 172A00000X
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Taxonomy Name | Driver
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License Number |
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License Number State | TX
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