Charles Eugene Rader, D.D.S.

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

11676 Issued in TX

Practice address

507 E Brazos St
Victoria, TX 77901-5261

Phone

(361) 576-5155

Fax

(361) 576-9228

NPI assigned

Jun 13, 2013

Last updated

Jun 13, 2013By 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 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Jun 18, 2015 through Jun 18, 2027

Medicare enrollment (NPD)

Enrolled

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 E. Rader, D.D.S.

  • Periodontics
  • Victoria, TX
  • NPI 1225118300
  Authorized official Same address or phone
• Citizens Medical Center County of Victoria

  • General Acute Care Hospital
  • Victoria, TX
  • NPI 1124052162
  NPD (past)

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

{
    "created_epoch": "1371081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1371081600000",
    "number": "1942648704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "507 E BRAZOS ST",
            "city": "VICTORIA",
            "state": "TX",
            "postal_code": "779015261",
            "telephone_number": "361-576-5155",
            "fax_number": "361-576-9228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "507 E BRAZOS ST",
            "city": "VICTORIA",
            "state": "TX",
            "postal_code": "779015261",
            "telephone_number": "361-576-5155",
            "fax_number": "361-576-9228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RADER",
        "first_name": "CHARLES",
        "middle_name": "EUGENE",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-06-13",
        "last_updated": "2013-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "TX",
            "license": "11676",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Qualthera Health Corporation (Central Drug)
• Richard Charles Quigley, D.O.
• Lisa Quintanilla, LPC ASSOCIATE, LCDC
• Julio Cesar Quiroz Olvera, MD
• Irfan Rashid Qureshi, M.D.
• Radiation Oncology Associates of South Texas, L.L.P. (Roast)
• Ganesh Venkataraman Raj, MD PHD
• Natalie Carol Ramirez, APRN, FNP-BC
• Betina Audra Ramos, MS CCC-SLP
• Diana Ramos, LVN

• Periodontics in Victoria, TX
• Providers in Victoria, TX by specialty
• Periodontics in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2013; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.