Charles Peter Anderson, MD
Individual provider Active NPI Family Medicine Physician · Kyle, TX
NPI 1992735500 · NPPES record last updated Nov 22, 2021
Key facts
- NPI
- 1992735500
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- E1801 (TX)
- Practice address
- 900 Rebel Road Unit 900
Kyle, TX 78640 - Phone
- (512) 491-3730
- Fax
- (512) 268-9129
- NPI assigned
- Jul 3, 2006
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- HHS exclusion list flag
- The National Provider Directory flags this NPI as appearing on an HHS exclusion list.
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| E1801 | TX | MD | Family Medicine Physician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | E1801 | TX | Yes |
Addresses
Primary practice location
900 Rebel Road Unit 900
Kyle, TX 78640
Mailing address
PO Box 1804
San Marcos, TX 78667-1804
Phone (512) 491-3730
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 121034601 | Medicaid | TX |
Other providers in Kyle, TX
- Fidelis Eze Amadi
- American Oncology Partners, P.a.
- Nirav Amin
- Brady E Anderson
- Cara Noelle Anderson
- Madelyn Andrade
- Alexandra Aponte
- Tristan Ardoin
- Jayla Rose Arellano I
- Amanda Jean Armstrong
All providers in Kyle, TX · Family Medicine Physician in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 22, 2021. 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.