Provider Demographics
NPI:1093386781
Name:CHAROENKIJKAJORN, CHAOW (MD)
Entity Type:Individual
Prefix:DR
First Name:CHAOW
Middle Name:
Last Name:CHAROENKIJKAJORN
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 1:1850 OLD MAIN ST APT 1616
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-2222
Mailing Address - Country:US
Mailing Address - Phone:281-660-2174
Mailing Address - Fax:
Practice Address - Street 1:6560 FANNIN ST STE 450
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-2735
Practice Address - Country:US
Practice Address - Phone:713-441-8823
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-05
Last Update Date:2023-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXBP10077150207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty