Provider Demographics
NPI:1073574091
Name:CHARRON, MARIA (MD)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:
Last Name:CHARRON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9201 PINECROFT DR STE 200
Mailing Address - Street 2:
Mailing Address - City:SHENANDOAH
Mailing Address - State:TX
Mailing Address - Zip Code:77380-3889
Mailing Address - Country:US
Mailing Address - Phone:281-863-9554
Mailing Address - Fax:832-232-5591
Practice Address - Street 1:9201 PINECROFT DR
Practice Address - Street 2:
Practice Address - City:SHENANDOAH
Practice Address - State:TX
Practice Address - Zip Code:77380-3889
Practice Address - Country:US
Practice Address - Phone:281-863-9554
Practice Address - Fax:832-232-5510
Is Sole Proprietor?:No
Enumeration Date:2006-03-29
Last Update Date:2023-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF5494208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0471088Medicaid
TX301746Medicare PIN
TXC14394Medicare UPIN
TX8C1258Medicare PIN