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Individual

SCOTT E CHARNITSKY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PAC

Contact information

Practice address
7707 FANNIN, SUITE 195, HOUSTON, TX 77054
(713) 797-0045
(713) 797-1821
Mailing address
7707 FANNIN, SUITE 195, HOUSTON, TX 77054
(713) 797-0045
(713) 797-1821

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
TX
363AM0700X
Medical Physician Assistant
Primary
000970
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
090970
CONNECTICARE
01
230590
PREFERRED ONE
01
290000970CT01
BLUE CROSS
01
2V3628
HEALTHNET MEDICAID
Enumeration date
11/09/2005
Last updated
12/06/2007
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