Provider Demographics
NPI:1164826046
Name:CHARTRES, INC.
Entity Type:Organization
Organization Name:CHARTRES, INC.
Other - Org Name:BRAZOS THERAPY CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHAIRMAN
Authorized Official - Prefix:MR
Authorized Official - First Name:DOUGLAS
Authorized Official - Middle Name:R
Authorized Official - Last Name:MEHLING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:903-525-3913
Mailing Address - Street 1:9846 HIGHWAY 31 E
Mailing Address - Street 2:
Mailing Address - City:TYLER
Mailing Address - State:TX
Mailing Address - Zip Code:75705-2329
Mailing Address - Country:US
Mailing Address - Phone:903-525-3913
Mailing Address - Fax:903-525-3867
Practice Address - Street 1:605 TOWNE OAKS DR
Practice Address - Street 2:
Practice Address - City:WACO
Practice Address - State:TX
Practice Address - Zip Code:76710-5965
Practice Address - Country:US
Practice Address - Phone:254-235-7604
Practice Address - Fax:254-235-7612
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-21
Last Update Date:2014-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation