MEDICARE: IGOR MATTHEW CHERCHES 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
1	2084N0400X	Neurology Physician	J1074	TX

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	130010358	OTHER	TX	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	0687279	OTHER	TX	AETNA

General Provider Information

NPI Number	:	1942295522
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	IGOR MATTHEW CHERCHES M.D.

Provider Business Mailing Address
First Line	:	6655 TRAVIS ST STE 600
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77030-1341
Country	:	US
Telephone Number	:	713-795-0074
Fax Number	:	713-795-5203

Provider Business Practice Location Address
First Line	:	6655 TRAVIS ST STE 600
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77030-1341
Country	:	US
Telephone Number	:	713-795-0074
Fax Number	:	713-795-5203

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

Provider Enumeration Date	:	09/20/2005
Last Update Date	:	07/21/2022

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