Charlie Wayne Propst, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

D6135 Issued in TX

Practice address

1100 S Beckham Ave
Tyler, TX 75701-3301

Phone

(903) 526-5660

Fax

(903) 526-5644

NPI assigned

Jul 8, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Wayne Propst Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1120780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1200873600000",
    "number": "1245238823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2021 HOLLY LEAF DR",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757030923",
            "telephone_number": "903-939-8395",
            "fax_number": "903-939-8612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 S BECKHAM AVE",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757013301",
            "telephone_number": "903-526-5660",
            "fax_number": "903-526-5644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PROPST",
        "first_name": "CHARLIE",
        "middle_name": "WAYNE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-08",
        "last_updated": "2008-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "D6135",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "0024GU",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "88Y133",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "WAYNE",
            "last_name": "PROPST",
            "credential": "MD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

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• Professional Dental Alliance of TX 43004 PLLC
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• Sherrie Amanda Prosper, COTA
• James Carey Prosperie, RPH
• Matthew F Prosser, D.D.S.
• Prosthetic-Orthotic Associates of East Texas, Inc.
• Julie Prothro, LPC-ASSCOCIATE

• Internal Medicine Physician in Tyler, TX
• Providers in Tyler, TX by specialty
• Internal Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.