Active NPI
Charles Richard Mabray, M.D.
- Gynecology Physician
- Victoria, TX
National Provider Identifier
1255336798
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gynecology Physician
- License
- D3325
- Practice address
- 115 Medical Dr
Ste 202
Victoria, TX 77904-3102 - Phone
- (361) 574-9697
- NPI assigned
- Jun 20, 2005
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gynecology Physician | 207VG0400X | D3325 | TX | Primary |
Addresses
Primary practice location
115 Medical Dr
Ste 202
Victoria, TX 77904-3102
Mailing address
115 Medical Dr
Ste 202
Victoria, TX 77904-3102
Phone (361) 574-9697
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D3325 | TX | MD | Gynecology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1119225600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1184198400000",
"number": "1255336798",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "115 MEDICAL DR",
"address_2": "STE 202",
"city": "VICTORIA",
"state": "TX",
"postal_code": "779043102",
"telephone_number": "361-574-9697"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "115 MEDICAL DR",
"address_2": "STE 202",
"city": "VICTORIA",
"state": "TX",
"postal_code": "779043102",
"telephone_number": "361-574-9697"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MABRAY",
"first_name": "CHARLES",
"middle_name": "RICHARD",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-06-20",
"last_updated": "2007-07-12",
"status": "A"
},
"taxonomies": [
{
"code": "207VG0400X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology, Gynecology",
"state": "TX",
"license": "D3325",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Victoria, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.