Individual
JEAN CHARLES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CSFA
Contact information
Practice address
619 ROLLINGBROOK ST APT 115, BAYTOWN, TX 77521-4065
(832) 262-6419
Mailing address
619 ROLLINGBROOK ST APT 115, BAYTOWN, TX 77521-4065
(832) 262-6419
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
147747
TX
363AS0400X
Surgical Physician Assistant
147747
TX
Other
Enumeration date
06/23/2014
Last updated
09/21/2014
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