MEDICARE: CHARNELL R CAIN DO

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	207Q00000X	Family Medicine Physician	CL0264	NV
2	207Q00000X	Family Medicine Physician	26767	MS
3	207Q00000X	Family Medicine Physician	3491	TN
4	207Q00000X	Family Medicine Physician	U0009	TX

General Provider Information

NPI Number	:	1265812630
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHARNELL R CAIN DO

Provider Business Mailing Address
First Line	:	12377 MERIT DR STE 300
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75251-3126
Country	:	US
Telephone Number	:	972-957-3000
Fax Number	:

Provider Business Practice Location Address
First Line	:	5230 ALDINE MAIL RTE
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77039-3804
Country	:	US
Telephone Number	:	281-598-3300
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/01/2015
Last Update Date	:	07/31/2024

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Directions to “ CHARNELL R CAIN DO” Practice Location

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