1972563237 NPI number — MR. CHARLES D DEES M.D

Table of content: MR. CHARLES D DEES M.D (NPI 1972563237)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1972563237 NPI number — MR. CHARLES D DEES M.D

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
DEES
Provider First Name:
CHARLES
Provider Middle Name:
D
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
Provider Credential Text:
M.D
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1972563237
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/12/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
BAYLOR SCOTT & WHITE MEDICAL CENTER
Provider Second Line Business Mailing Address:
100 HILLCREST MEDICAL BLVD
Provider Business Mailing Address City Name:
WACO
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
76712-8897
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
540-536-8000
Provider Business Mailing Address Fax Number:
540-536-7681

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1840 AMHERST ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WINCHESTER
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
22601-2808
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
540-536-8000
Provider Business Practice Location Address Fax Number:
540-536-7681
Provider Enumeration Date:
03/23/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207P00000X , with the licence number:  N6123 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 207P00000X , with the licence number: 0101236525 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 3810002451 , issued by the state of ( WV ) . This identifiers is of the category "MEDICAID".
  • Identifier: 010151317 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".




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