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NPI Code Detail

MEDICARE: CHARLENE D CAID PH.D.

MEDICARE: CHARLENE D CAID PH.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
1103TC0700XClinical Psychologist2-3428TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
110008948OTHERTXAMERIGROUP
2044152OTHERTXVALUE OPTIONS
300D88BOTHERTXBLUE CROSS BLUE SHIELD
4MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1528090842
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHARLENE D CAID PH.D.
Provider Business Mailing Address
First Line : 2524 NOTTINGHAM ST
Second Line :
City : HOUSTON
State : TX
Zip : 77005-1412
Country : US
Telephone Number : 713-526-3218
Fax Number : 713-526-4342
Provider Business Practice Location Address
First Line : 2524 NOTTINGHAM ST
Second Line :
City : HOUSTON
State : TX
Zip : 77005-1412
Country : US
Telephone Number : 713-526-3218
Fax Number : 713-526-4342
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/07/2006
Last Update Date : 07/09/2007

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Directions to “ CHARLENE D CAID PH.D.” Practice Location

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