Provider Demographics
NPI:1114919412
Name:TUEN, CHARLES C (MD)
Entity Type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:C
Last Name:TUEN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1001 ROBBIE MINCE WAY
Mailing Address - Street 2:STE C
Mailing Address - City:DESOTO
Mailing Address - State:TX
Mailing Address - Zip Code:75115-3461
Mailing Address - Country:US
Mailing Address - Phone:214-943-8887
Mailing Address - Fax:214-943-5016
Practice Address - Street 1:1001 ROBBIE MINCE WAY
Practice Address - Street 2:STE C
Practice Address - City:DESOTO
Practice Address - State:TX
Practice Address - Zip Code:75115
Practice Address - Country:US
Practice Address - Phone:214-943-8887
Practice Address - Fax:214-943-5016
Is Sole Proprietor?:No
Enumeration Date:2005-08-22
Last Update Date:2022-01-17
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXG60352084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX126285906Medicaid
TXB27123Medicare UPIN
TX126285906Medicaid
TX8F6914Medicare PIN