Black, Charles Thomas

Black, Charles Thomas is an sole proprietor health care provider with primary practice located at 12200 Park Central Dr Ste 400 , Dallas TX 75251-2116. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatric Surgery, which is considered as his primary health care specialty. Black, Charles Thomas can be contacted via phone (214) 483-9300.

Contact Information

Primary practice address
12200 Park Central Dr Ste 400 Dallas TX 75251-2116
Phone: (214) 483-9300
Fax: (214) 483-9301
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatric Surgery 2086S0120X F3761 Texas

Profile Details

NPI number 1528049723
LBN Legal business name Black, Charles Thomas
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Nov 7th, 2005
Last updated May 13th, 2020 - about 5 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1528049723 NPPES
Texas Other 4130343 AETNA
Texas MEDICAID 138311911 AETNA
Texas Other 389962 AETNA
Texas Other 127631 AETNA
Texas Other 80390N AETNA
Texas Other 153410004 AETNA
Texas Other 3725428015 AETNA
Texas Other 138311914 AETNA
Texas Other 41814 AETNA
Texas Other 0134405 AETNA
Texas Other 10009560 AETNA
Texas MEDICAID 138311913 AETNA

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