Individual
CHARLIE WAYNE PROPST
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1100 S BECKHAM AVE, TYLER, TX 75701-3301
(903) 526-5660
(903) 526-5644
Mailing address
2021 HOLLY LEAF DR, TYLER, TX 75703-0923
(903) 939-8395
(903) 939-8612
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
D6135
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0024GU
BLUE CROSS
TX
01
—
88Y133
BLUE CROSS
TX
Enumeration date
07/08/2005
Last updated
01/21/2008
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