Basic Information
Provider Information
NPI: 1861928996
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: CABIOS
FirstName: CHARLTON
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: PT
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 500 LINDBERG AVE
Address2:  
City: MCALLEN
State: TX
PostalCode: 785012924
CountryCode: US
TelephoneNumber: 9566874560
FaxNumber:  
Practice Location
Address1: 630 E BRAVO BLVD STE 2
Address2:  
City: ROMA
State: TX
PostalCode: 785845721
CountryCode: US
TelephoneNumber: 9568474424
FaxNumber:  
Other Information
ProviderEnumerationDate: 05/10/2017
LastUpdateDate: 05/10/2017
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
208100000X1289128TXY Allopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation 

No ID Information.


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