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Individual
CHARLES E WILLIS
Active
Individual
CHARLES E WILLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
J0365
TX
207LP2900X
Pain Medicine (Anesthesiology) Physician
J0365
TX
208VP0000X
Pain Medicine Physician
Primary
J0365
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00R03P
BCBS
TX
05
—
134219808
—
TX
Enumeration date
05/27/2005
Last updated
01/27/2026
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