Individual
CHARLES EDWIN MORITZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2401 S 31ST ST, TEMPLE, TX 76508-1808
(254) 724-2111
Mailing address
PO BOX 844658, DALLAS, TX 75284-4658
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
G8301
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1851328124
00R28H
TX
05
—
P080X8406
—
TX
Enumeration date
06/26/2006
Last updated
01/26/2022
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