Individual
CHARLES COLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
2801 FRANCISCAN DR, BRYAN, TX 77802-2544
(979) 776-5967
(979) 774-4849
Mailing address
5410 MARYLAND WAY, SUITE 300, BRENTWOOD, TN 37027-5064
(615) 377-5652
(888) 241-1404
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
42220
CO
207Q00000X
Family Medicine Physician
Primary
N3570
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
208601901
—
TX
01
—
8V4248
TX BCBS
TX
05
—
95109773
—
CO
Enumeration date
08/20/2006
Last updated
04/16/2010
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