Provider Demographics
NPI:1174542039
Name:CRIM, CHARLES BRIAN (MD)
Entity type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:BRIAN
Last Name:CRIM
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:2965 HARRISON ST
Mailing Address - Street 2:#217
Mailing Address - City:BEAUMONT
Mailing Address - State:TX
Mailing Address - Zip Code:77702-1100
Mailing Address - Country:US
Mailing Address - Phone:409-892-4664
Mailing Address - Fax:409-892-3730
Practice Address - Street 1:2965 HARRISON ST
Practice Address - Street 2:#217
Practice Address - City:BEAUMONT
Practice Address - State:TX
Practice Address - Zip Code:77702-1100
Practice Address - Country:US
Practice Address - Phone:409-892-4664
Practice Address - Fax:409-892-3730
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXD5947207NS0135X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207NS0135XAllopathic & Osteopathic PhysiciansDermatologyProcedural Dermatology