Basic Information
| Provider Information | |||||||||
| NPI: | 1306118013 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CHARTAN | ||||||||
| FirstName: | COREY | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Mailing Information | |||||||||
| Address1: | ONE BAYLOR PLAZA, MAIL STOP W6-006 | ||||||||
| Address2: | PEDIATRIC CRITICAL CARE | ||||||||
| City: | HOUSTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 77070 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7137984780 | ||||||||
| FaxNumber: | 7137901345 | ||||||||
| Practice Location | |||||||||
| Address1: | ONE BAYLOR PLAZA, MAIL STOP W6-006 | ||||||||
| Address2: | PEDIATRIC CRITICAL CARE | ||||||||
| City: | HOUSTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 77070 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7137984780 | ||||||||
| FaxNumber: | 7137901345 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/27/2012 | ||||||||
| LastUpdateDate: | 06/28/2013 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2080P0203X | P6151 | TX | Y | Allopathic & Osteopathic Physicians | Pediatrics | Pediatric Critical Care Medicine |
No ID Information.