Tatum, Charles H

Tatum, Charles H is an sole proprietor health care provider with primary practice located at 12050 Vance Jackson Rd. Bldg. 2 Suite 201, San Antonio TX 78230-1183. He recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Cognitive & Behavioral, Behavioral Health & Social Service Providers / Marriage & Family Therapist, Behavioral Health & Social Service Providers / Professional. Behavioral Health & Social Service Providers / Professional is his primary health care specialty. Tatum, Charles H can be contacted via phone (210) 699-8881.

Contact Information

Primary practice address
12050 Vance Jackson Rd. Bldg. 2 Suite 201 San Antonio TX 78230-1183
Phone: (210) 699-8881
Fax: (210) 699-0503
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Cognitive & Behavioral 103TB0200X 10968 Texas
Behavioral Health & Social Service Providers / Marriage & Family Therapist 106H00000X 1884 Texas
Behavioral Health & Social Service Providers / Professional 101YP2500X 8835 Texas

Profile Details

NPI number 1851317895
LBN Legal business name Tatum, Charles H
Credentials PHD
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 14th, 2006
Last updated Mar 13th, 2024 - about last year

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 1851317895 NPPES
Texas MEDICAID 027365801

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