Charles Michael Altman, DDS
Individual provider Active NPI Dentist · Brenham, TX
NPI 1922258797 · NPPES record last updated Sep 29, 2008
Key facts
- NPI
- 1922258797
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 17262 (TX)
- Practice address
- 1306 S Blue Bell Rd
Brenham, TX 77833-4418 - Phone
- (979) 836-6767
- Fax
- (979) 836-5604
- NPI assigned
- Sep 29, 2008
- Sex
- Male
- Sole proprietor
- No
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)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 17262 | TX | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| C Michael Altman DDS PC | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 17262 | TX | Yes |
Addresses
Primary practice location
1306 S Blue Bell Rd
Brenham, TX 77833-4418
Mailing address
1306 S Blue Bell Rd
Brenham, TX 77833-4418
Phone (979) 836-6767
Other providers in Brenham, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 29, 2008. 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.