Charles Richard Payerle Jr., DDS MD

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

0023735 Issued in TX

Practice address

12001 South Fwy Ste 207
Burleson, TX 76028-7214

Phone

(817) 568-6811

NPI assigned

May 23, 2007

Last updated

Jan 4, 2010By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Charles R Payerle DDS, MD PLLC

  • Oral and Maxillofacial Surgery Clinic/Center
  • Burleson, TX
  • NPI 1558791566
  Authorized official Same address or phone
• Charles R Payerle, DDS, MD, PLLC

  • Oral and Maxillofacial Surgery (Dentist)
  • Burleson, TX
  • NPI 1871819292
  NPD (past) Authorized official

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

{
    "created_epoch": "1179878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1262563200000",
    "number": "1780894170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12001 S FREEWAY",
            "address_2": "#207",
            "city": "BURLESON",
            "state": "TX",
            "postal_code": "76028",
            "telephone_number": "817-568-6811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12001 SOUTH FWY STE 207",
            "city": "BURLESON",
            "state": "TX",
            "postal_code": "760287214",
            "telephone_number": "817-568-6811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAYERLE",
        "first_name": "CHARLES",
        "middle_name": "RICHARD",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "DDS MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-23",
        "last_updated": "2010-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "TX",
            "license": "0023735",
            "primary": true
        },
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "LA",
            "license": "S-355",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hardik Chandrakant Patel, LICENSED PHARMACIST
• Imran A Patel, MD
• Mihir V Patel, M.D.
• Shiv Pravin Patel, MD
• Amy Patton
• Howard Whitney Payne Jr., DDS MPH
• Peak Physical Therapy, LLC
• Pecan Valley MHMR Region
• Pecan Valley MHMR Region
• Kelsey Pecsek, LPC ASSOCIATE

• Oral and Maxillofacial Surgery (Dentist) in Burleson, TX
• Providers in Burleson, TX by specialty
• Oral and Maxillofacial Surgery (Dentist) in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2010; 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.