Provider Demographics
NPI:1427386358
Name:CHARLES F. MILD, MD, FACC, FSCAI, PA
Entity Type:Organization
Organization Name:CHARLES F. MILD, MD, FACC, FSCAI, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:F
Authorized Official - Last Name:MILD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:956-421-5111
Mailing Address - Street 1:2121 PEASE ST
Mailing Address - Street 2:SUITE 407
Mailing Address - City:HARLINGEN
Mailing Address - State:TX
Mailing Address - Zip Code:78550-8348
Mailing Address - Country:US
Mailing Address - Phone:956-421-5111
Mailing Address - Fax:956-421-5221
Practice Address - Street 1:2121 PEASE ST
Practice Address - Street 2:SUITE 407
Practice Address - City:HARLINGEN
Practice Address - State:TX
Practice Address - Zip Code:78550-8348
Practice Address - Country:US
Practice Address - Phone:956-421-5111
Practice Address - Fax:956-421-5221
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-04
Last Update Date:2009-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH6895207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional CardiologyGroup - Single Specialty