Provider Demographics
NPI:1346358413
Name:BREELING, CHARLES L (MD)
Entity Type:Individual
Prefix:
First Name:CHARLES
Middle Name:L
Last Name:BREELING
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:3301 S ALAMEDA ST
Mailing Address - Street 2:SUITE 201
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78411-1882
Mailing Address - Country:US
Mailing Address - Phone:361-857-2900
Mailing Address - Fax:361-857-8321
Practice Address - Street 1:3301 S ALAMEDA ST
Practice Address - Street 2:SUITE 201
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78411-1882
Practice Address - Country:US
Practice Address - Phone:361-857-2900
Practice Address - Fax:361-857-8321
Is Sole Proprietor?:No
Enumeration Date:2006-08-28
Last Update Date:2022-02-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXF9232207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX138033904Medicaid
TX138033904Medicaid
A02031Medicare UPIN