Individual
CHARLES ALFRED ILIYA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
8230 WALNUT HILL LN STE 320, DALLAS, TX 75231-4481
(214) 369-5432
(214) 369-5591
Mailing address
8230 WALNUT HILL LN STE 320, DALLAS, TX 75231-4481
(214) 369-5432
(214) 369-5591
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
G5202
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
114061803
—
TX
Enumeration date
03/20/2007
Last updated
09/30/2021
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