Individual
DR. CHARLES RICHARD PAYERLE JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS MD
Contact information
Practice address
12001 SOUTH FWY STE 207, BURLESON, TX 76028-7214
(817) 568-6811
Mailing address
12001 S FREEWAY, #207, BURLESON, TX 76028
(817) 568-6811
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
0023735
TX
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
S-355
LA
Other
Enumeration date
05/23/2007
Last updated
01/04/2010
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