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General NPI Number Information
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NPI Number | 1659443851
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Entity Type | Organization
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Legal Business Name | CHARLES H. WAHLERT MDPA
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Dates
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Enumeration Date | 11/14/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 521 BRYAN ST
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City | DENTON
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State | TX
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Zip | 76201-2705
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Country | US
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Telephone | 940-380-1985
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Fax | 940-382-6728
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Provider Business Mailing Address
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Address Line | 521 BRYAN ST
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City | DENTON
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State | TX
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Zip | 76201-2705
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Country | US
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Telephone | 940-380-1985
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Fax | 940-382-6728
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Authorized Official
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Title or Position | C.E.O.
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Name | DR. CHARLES H. WAHLERT
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Credential | M.D.
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Telephone | 940-380-1985
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | E6190
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License Number State | TX
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