MEDICARE: JULIE ANNE CHARTERS PA-C

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	363A00000X	Physician Assistant	PA05809	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	1629307806	OTHER	BLUE CROSS BLUE SHIELD TX
2	1629307806	OTHER	TRICARE SOUTH
3	825N61	OTHER	BLUE CROSS BLUE SHIELD TX INTERNAL#

General Provider Information

NPI Number	:	1629307806
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JULIE ANNE CHARTERS PA-C

Provider Business Mailing Address
First Line	:	2800 ALDINE BENDER RD STE B
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77032-3502
Country	:	US
Telephone Number	:	281-977-3800
Fax Number	:

Provider Business Practice Location Address
First Line	:	2800 ALDINE BENDER RD STE B
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77032-3502
Country	:	US
Telephone Number	:	281-977-3800
Fax Number	:

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

Provider Enumeration Date	:	12/16/2009
Last Update Date	:	06/20/2013

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