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General NPI Number Information
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NPI Number | 1588843239
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Entity Type | Organization
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Legal Business Name | CHARLES J. BURCH, M.D., P.A.
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Dates
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Enumeration Date | 10/30/2007
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Last Update Date | 02/10/2022
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Provider Practice Location Address
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Address Line | 4458 MEDICAL DR STE 505
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City | SAN ANTONIO
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State | TX
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Zip | 78229-3748
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Country | US
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Telephone | 210-690-7400
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Fax | 210-690-7405
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Provider Business Mailing Address
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Address Line | 4458 MEDICAL DR STE 505
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City | SAN ANTONIO
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State | TX
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Zip | 78229-3748
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Country | US
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Telephone | 210-690-7400
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Fax | 210-690-7405
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Authorized Official
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Title or Position | MD/OWNER
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Name | CHARLES J BURCH
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Credential | MD
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Telephone | 210-690-7400
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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 | K2657
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License Number State | TX
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