# CHARLES E. WILLIS II, M.D., P.A.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1295862431
- **Authorized official:** DR. CHARLES E. WILLIS II M.D. (PRESIDENT)
- **Authorized official phone:** (214) 623-0550

## Contact information

- **Practice address:** 5201 S WESTMORELAND RD, DALLAS, TX 75237-1622
- **Practice address phone:** (214) 623-0550
- **Mailing address:** PO BOX 1347, ADDISON, TX 75001-1347
- **Mailing address phone:** (972) 991-9950

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician | J0365 | TX | Yes |

## Other

- **Enumeration date:** 02/27/2007
- **Last updated:** 05/10/2008