Provider Demographics
NPI:1245386424
Name:GNAIM, CHARLIE ISSA (MD)
Entity Type:Individual
Prefix:
First Name:CHARLIE
Middle Name:ISSA
Last Name:GNAIM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:18450 HIGHWAY 59 N
Mailing Address - Street 2:
Mailing Address - City:HUMBLE
Mailing Address - State:TX
Mailing Address - Zip Code:77338-4404
Mailing Address - Country:US
Mailing Address - Phone:281-446-6656
Mailing Address - Fax:281-446-6657
Practice Address - Street 1:18450 HIGHWAY 59 N
Practice Address - Street 2:
Practice Address - City:HUMBLE
Practice Address - State:TX
Practice Address - Zip Code:77338-4404
Practice Address - Country:US
Practice Address - Phone:281-446-6656
Practice Address - Fax:281-446-6657
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-28
Last Update Date:2024-01-29
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXM0413207RI0011X, 207RI0011X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology