Provider Demographics
NPI:1205416781
Name:TSAI, CHARLES CHIA
Entity Type:Individual
Prefix:
First Name:CHARLES
Middle Name:CHIA
Last Name:TSAI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5900 W PLEASANT RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76016-4427
Mailing Address - Country:US
Mailing Address - Phone:817-478-6041
Mailing Address - Fax:
Practice Address - Street 1:5900 W PLEASANT RIDGE RD
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76016-4427
Practice Address - Country:US
Practice Address - Phone:817-478-6041
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-09
Last Update Date:2021-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX38332183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist