Provider Demographics
NPI:1225056328
Name:BYRD, CHARLES RONALD (MD)
Entity Type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:RONALD
Last Name:BYRD
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:2765 BEE CAVE RD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78746-5640
Mailing Address - Country:US
Mailing Address - Phone:512-328-2752
Mailing Address - Fax:512-328-2751
Practice Address - Street 1:2712 BEE CAVE RD
Practice Address - Street 2:SUITE 122
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78746-5676
Practice Address - Country:US
Practice Address - Phone:512-328-2752
Practice Address - Fax:512-328-2751
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-17
Last Update Date:2011-07-27
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Provider Licenses
StateLicense IDTaxonomies
TXJ5718207Q00000X
LA021577207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXG02262Medicare UPIN