Individual
MR. CHARLES T STILES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2401 S 31ST ST, TEMPLE, TX 76508-0001
(254) 724-2111
Mailing address
PO BOX 844658, DALLAS, TX 75284-4658
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
J2984
TX
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
J2984
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00U55H
BCBS
TX
05
—
137900003
—
TX
05
—
137900013
—
TX
Enumeration date
04/18/2006
Last updated
02/28/2014
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