Provider Demographics
NPI:1376253781
Name:MEADOWS, CHARLES ALVIN JR
Entity Type:Individual
Prefix:MR
First Name:CHARLES
Middle Name:ALVIN
Last Name:MEADOWS
Suffix:JR
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 1:21013 OLD SORTERS RD STE C
Mailing Address - Street 2:
Mailing Address - City:PORTER
Mailing Address - State:TX
Mailing Address - Zip Code:77365-7083
Mailing Address - Country:US
Mailing Address - Phone:281-747-7445
Mailing Address - Fax:281-605-5337
Practice Address - Street 1:21013 OLD SORTERS RD STE C
Practice Address - Street 2:
Practice Address - City:PORTER
Practice Address - State:TX
Practice Address - Zip Code:77365-7083
Practice Address - Country:US
Practice Address - Phone:281-747-7445
Practice Address - Fax:281-605-5337
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-28
Last Update Date:2022-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX345291835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist