Provider Demographics
NPI:1275541484
Name:MORRIS, CHARLES JAY (MD)
Entity Type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:JAY
Last Name:MORRIS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:2258 BANCROFT ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77027-3706
Mailing Address - Country:US
Mailing Address - Phone:832-767-3409
Mailing Address - Fax:713-961-4431
Practice Address - Street 1:1333 WEST LOOP S
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77027-9116
Practice Address - Country:US
Practice Address - Phone:713-296-4849
Practice Address - Fax:713-961-4431
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-03
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXG5401207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXG5401OtherTEXAS LICENSE NUMBER
TXAM2559524OtherDEA REGISTRATION NUMBER
TXC19621Medicare UPIN