Individual
DR. CHARLES E HERLIHY JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
530 SILICON DR, SUITE 103, SOUTHLAKE, TX 76092-9017
(817) 442-0200
(817) 442-0204
Mailing address
104 SYCAMORE CT, GRAPEVINE, TX 76051-8259
(251) 490-7527
(817) 442-0204
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
00008022
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000009927
—
AL
Enumeration date
11/29/2005
Last updated
06/21/2024
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