Charles M McClean DO PA

Primary specialty

Infectious Disease PhysicianTaxonomy code 207RI0200X

License

J0590 Issued in TX

Legal business name

CHARLES M MCCLEAN DO PA

Practice address

3600 Matlock Rd
106
Arlington, TX 76015-3679

Phone

(817) 557-1900

Fax

(817) 557-1942

NPI assigned

Nov 29, 2010

Last updated

Jun 9, 2011By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Charles M McClean, D.ONPI 1144272071

Title

Owner

Phone

(817) 557-1900

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Charles M McClean, D.O.

  • Infectious Disease Physician
  • Arlington, TX
  • NPI 1144272071
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1290988800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1307577600000",
    "number": "1093017964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3600 MATLOCK RD",
            "address_2": "106",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760153679",
            "telephone_number": "817-557-1900",
            "fax_number": "817-557-1942"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3600 MATLOCK RD",
            "address_2": "106",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760153679",
            "telephone_number": "817-557-1900",
            "fax_number": "817-557-1942"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHARLES M MCCLEAN DO PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-29",
        "last_updated": "2011-06-09",
        "status": "A",
        "authorized_official_last_name": "MCCLEAN",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "817-557-1900",
        "authorized_official_credential": "D.O"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "TX",
            "license": "J0590",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "033813901",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Chartwell Community Services, Inc (Jordan Health Service, a Part of the Elara Caring Network)

• Infectious Disease Physician in Arlington, TX
• Providers in Arlington, TX by specialty
• Infectious Disease Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.