Individual
DR. CHARLES M GOTTLICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
621 N HALL ST, SUITE 500, DALLAS, TX 75226-1339
(214) 841-2000
(214) 841-2015
Mailing address
16980 DALLAS PKWY, SUITE 200, DALLAS, TX 75248-1908
(972) 391-1915
(972) 391-2061
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
D7059
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
129167603
—
TX
Enumeration date
04/14/2006
Last updated
07/09/2010
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