Charles William Hall Sr., PA
Individual provider Active NPI Medical Physician Assistant · China, TX
NPI 1407997646 · NPPES record last updated Mar 5, 2012
Key facts
- NPI
- 1407997646
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Medical Physician Assistant 363AM0700X
- License
- PA01495 (TX)
- Practice address
- 415 N Broadway
China, TX 77613 - Phone
- (409) 752-2301
- Fax
- (409) 752-5054
- NPI assigned
- Feb 9, 2007
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| China Community Clinic,LLC | Medical | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | PA01495 | TX | Yes |
Addresses
Primary practice location
415 N Broadway
China, TX 77613
Mailing address
PO Box 786
China, TX 77613-0786
Phone (409) 752-2301
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 141597803 | Medicaid | TX | |
| PA01495 | Other | TX | LICENSE NUMBER |
Other providers in China, TX
- China Community Clinic LLC
- China Community Clinic,LLC
- Drugstore in China
- Kacey Erin Durden
- H&H China Pharmacy LLC
- Hardin-Jefferson Isd
- High Island Isd
- Stephanie Quave
All providers in China, TX · Medical Physician Assistant in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 5, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.