Individual
CHARLES THOMAS BLACK
Active
Individual
CHARLES THOMAS BLACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
2086S0120X
Pediatric Surgery Physician
Primary
F3761
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0134405
UNITED HEALTH CARE
TX
01
—
10009560
AMERIGROUP
TX
01
—
127631
SUPERIOR CHIP
TX
05
—
138311911
—
TX
05
—
138311913
—
TX
01
—
138311914
CSHCN
TX
01
—
153410004
PACIFICARE
TX
01
—
3725428015
CIGNA
TX
01
—
389962
ONE HEALTH PLAN
TX
01
—
4130343
AETNA
TX
01
—
41814
AETNA MEDICAID
TX
01
—
80390N
BLUE CROSS
—
Enumeration date
11/07/2005
Last updated
05/13/2020
Update your record
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