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:
Health care specialties
| Specialty | Code | License # | 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| 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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