Organization
CHARLES M MCCLEAN DO PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLES M MCCLEAN D.O (OWNER)
(817) 557-1900
Entity
Organization
Contact information
Practice address
3600 MATLOCK RD, 106, ARLINGTON, TX 76015-3679
(817) 557-1900
(817) 557-1942
Mailing address
3600 MATLOCK RD, 106, ARLINGTON, TX 76015-3679
(817) 557-1900
(817) 557-1942
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
J0590
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
033813901
—
TX
Enumeration date
11/29/2010
Last updated
06/09/2011
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