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NPI Code Detail

MEDICARE: CHARLES STUMP

MEDICARE: CHARLES STUMP
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
1183500000XPharmacist24925TX

General Provider Information

NPI Number : 1629380084
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHARLES STUMP
Provider Business Mailing Address
First Line : 3663 BRIARPARK DR
Second Line :
City : HOUSTON
State : TX
Zip : 77042-5205
Country : US
Telephone Number : 713-268-3630
Fax Number : 623-869-1717
Provider Business Practice Location Address
First Line : 101 TROPHY LAKE DR
Second Line :
City : TROPHY CLUB
State : TX
Zip : 76262-5233
Country : US
Telephone Number : 817-490-6968
Fax Number : 817-490-6985
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/13/2010
Last Update Date : 07/13/2010

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Directions to “ CHARLES STUMP ” Practice Location

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