Basic Information
| Provider Information | |||||||||
| NPI: | 1891795001 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | GEYER | ||||||||
| FirstName: | CHARLES | ||||||||
| MiddleName: | E | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | JR. | ||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6445 MAIN ST FL 24 | ||||||||
| Address2: | |||||||||
| City: | HOUSTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 770301502 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7134419948 | ||||||||
| FaxNumber: | 7134418791 | ||||||||
| Practice Location | |||||||||
| Address1: | 6445 MAIN ST FL 24 | ||||||||
| Address2: | |||||||||
| City: | HOUSTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 770301502 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7134419948 | ||||||||
| FaxNumber: | 7134418791 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/29/2005 | ||||||||
| LastUpdateDate: | 06/23/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 06/23/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | F6662 | TX | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207RH0003X | 0101254387 | VA | N | Allopathic & Osteopathic Physicians | Internal Medicine | Hematology & Oncology | 207RX0202X | MD419017 | PA | N | Allopathic & Osteopathic Physicians | Internal Medicine | Medical Oncology | 207RH0003X | F6662 | TX | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Hematology & Oncology |
ID Information
| ID | Type | State | Issuer | Description | 202569406 | 05 | TX | MEDICAID | 2342334 | 05 | OH | MEDICAID | 0019157400001 | 05 | PA | MEDICAID | 3810011108 | 05 | WV | MEDICAID | 905763 | 01 | TX | MEDICARE NUMBER IND | OTHER |