Provider Demographics
NPI:1164568283
Name:SWEET, CHARLES THOMAS (MD, MPH)
Entity Type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:THOMAS
Last Name:SWEET
Suffix:
Gender:M
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2217 PARK BEND DR STE 300
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78758-5674
Mailing Address - Country:US
Mailing Address - Phone:512-382-1933
Mailing Address - Fax:512-778-8000
Practice Address - Street 1:2217 PARK BEND DR STE 300
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78758-5674
Practice Address - Country:US
Practice Address - Phone:512-382-1933
Practice Address - Fax:512-778-8000
Is Sole Proprietor?:No
Enumeration Date:2007-01-29
Last Update Date:2024-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC1722582084P0800X
TXN11702084P0804X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX199975701Medicaid
TXN1170OtherMEDICAL LICENSE
TX8L4842Medicare PIN