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Individual

CHARLES ASWELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
800 E DAWSON ST, TYLER, TX 75701-2036
(903) 606-4522
(865) 541-2787
Mailing address
PO BOX 841656, DALLAS, TX 75284-1656
(903) 531-5000

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
11871
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
100050404
PHP TENNCARE
TN
05
3636288
TN
05
379954601
TX
05
379954603
TX
01
4121475
BLUECARE
TN
01
616376YQ8A
MEDICARE
TX
01
723877
MEDICARE
TX
01
75-0818167-015
TRICARE
TX
01
8HB331
BCBS
TX
01
8JN057
BCBS
TX
01
P00285225
MEDICARE TRAVELERS
TN
01
P01938569
MEDICARE RAIL ROAD
TX
01
P02136788
MEDICARE RAIL ROAD
TX
Enumeration date
06/10/2006
Last updated
01/28/2019
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