MEDICARE: CHARTRES, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QR0400X	Rehabilitation Clinic/Center

General Provider Information

NPI Number	:	1164826046
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHARTRES, INC.

Provider Business Mailing Address
First Line	:	9846 HIGHWAY 31 E
Second Line	:
City	:	TYLER
State	:	TX
Zip	:	75705-2329
Country	:	US
Telephone Number	:	903-525-3913
Fax Number	:	903-525-3867

Provider Business Practice Location Address
First Line	:	605 TOWNE OAKS DR
Second Line	:
City	:	WACO
State	:	TX
Zip	:	76710-5965
Country	:	US
Telephone Number	:	254-235-7604
Fax Number	:	254-235-7612

Authorized Official
Title or Position	:	CHAIRMAN
Name	:	MR. DOUGLAS R. MEHLING
Credential	:
Telephone Number	:	903-525-3913

Provider Enumeration Date	:	10/21/2014
Last Update Date	:	10/21/2014

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Directions to “CHARTRES, INC. ” Practice Location

Language	Start Address	Practice Location

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