Provider Demographics
NPI:1083819262
Name:MULLINS, CHARLES BROWN (MD)
Entity Type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:BROWN
Last Name:MULLINS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4203 FARHILLS DR
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78731-2813
Mailing Address - Country:US
Mailing Address - Phone:512-346-0400
Mailing Address - Fax:512-346-5854
Practice Address - Street 1:4203 FARHILLS DR
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78731-2813
Practice Address - Country:US
Practice Address - Phone:512-346-0400
Practice Address - Fax:512-346-5854
Is Sole Proprietor?:No
Enumeration Date:2007-06-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXC7066207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine