Individual provider Active NPI

Charles Eugene Fontanier, DO

  • General Practice Physician
  • Houston, TX
National Provider Identifier
1689756918
Registry record updated Jul 8, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
F3960 Issued in TX
Practice address
210 W Greens Rd
Suite C
Houston, TX 77067
Phone
(281) 872-7676
Fax
(281) 872-0569
NPI assigned
Oct 19, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X F3960 TX Primary

Addresses

Primary practice location

210 W Greens Rd
Suite C
Houston, TX 77067

Mailing address

210 W Greens Rd
Suite C
Houston, TX 77067-4605
Phone (281) 872-7676

Other identifiers 1

IdentifierTypeStateIssuer
115903001MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120202000774 TX Practitioner - Family PracticePractitioner - General PracticePractitioner - Osteopathic Manipulative MedicinePractitioner - Colorectal Surgery (Proctology) 3870750896 Practice locations: Houston, TX

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Colorectal Surgery (Proctology), General Practice, Osteopathic Manipulative Medicine
Education
Other, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

210 W Greens Rd
Suite C
Houston, TX 77067-4610
Phone (281) 872-7676

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

NPI Registry JSON

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

{
    "created_epoch": "1161216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1278547200000",
    "number": "1689756918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 W GREENS RD",
            "address_2": "SUITE C",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770674605",
            "telephone_number": "281-872-7676",
            "fax_number": "281-872-0569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 W GREENS RD",
            "address_2": "SUITE C",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "77067",
            "telephone_number": "281-872-7676",
            "fax_number": "281-872-0569"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FONTANIER",
        "first_name": "CHARLES",
        "middle_name": "EUGENE",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-19",
        "last_updated": "2010-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "TX",
            "license": "F3960",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "115903001",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.