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NPI Code Detail

MEDICARE: CHARLES C RISINGER M.D.

MEDICARE: CHARLES C RISINGER M.D.
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
1207Q00000XFamily Medicine PhysicianG8376TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
28125J2OTHERTXBCBSTX

General Provider Information

NPI Number : 1386665982
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHARLES C RISINGER M.D.
Provider Business Mailing Address
First Line : 200 N VIRGINIA ST
Second Line :
City : TERRELL
State : TX
Zip : 75160-2732
Country : US
Telephone Number : 972-551-7500
Fax Number : 972-524-7418
Provider Business Practice Location Address
First Line : 200 N VIRGINIA ST
Second Line :
City : TERRELL
State : TX
Zip : 75160-2732
Country : US
Telephone Number : 972-551-7500
Fax Number : 972-524-7418
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/21/2006
Last Update Date : 01/25/2023

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