Avera, Charles Blake
Avera, Charles Blake is an individual health care provider with primary practice located at 1704 11Th St , Wichita Falls TX 76301-5020. He recently has only one registered license in Allopathic & Osteopathic Physicians / Ophthalmology, which is considered as his primary health care specialty. Avera, Charles Blake can be contacted via phone (940) 723-1274.Contact Information
Primary practice address
1704 11Th St
Wichita Falls TX 76301-5020
Phone: (940) 723-1274
Fax: (940) 723-1525
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Ophthalmology | 207W00000X | H224 | Texas |
Profile Details
| NPI number | 1144281544 |
|---|---|
| LBN Legal business name | Avera, Charles Blake |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 28th, 2006 |
| Last updated | Dec 10th, 2013 - about 12 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1144281544 | NPPES |
| Texas | MEDICAID | 137823407 |
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