Individual
CHARLES T MAXVILL JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
251 WESTPARK WAY STE 210, EULESS, TX 76040-3742
(682) 236-3656
(855) 813-9308
Mailing address
251 WESTPARK WAY STE 210, EULESS, TX 76040-3742
(682) 236-3656
(855) 813-9308
Taxonomy
Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
F5299
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1318080107
—
TX
05
—
131808108
—
TX
05
—
131808109
—
TX
05
—
131808110
—
TX
05
—
131808114
—
TX
Enumeration date
07/26/2006
Last updated
09/02/2014
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