Provider Demographics
NPI:1437133725
Name:SCHWARTZ, CHARLES III (DO)
Entity Type:Individual
Prefix:
First Name:CHARLES
Middle Name:
Last Name:SCHWARTZ
Suffix:III
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6801 MCPHERSON AVE
Mailing Address - Street 2:#332
Mailing Address - City:LAREDO
Mailing Address - State:TX
Mailing Address - Zip Code:78041-6402
Mailing Address - Country:US
Mailing Address - Phone:956-795-1991
Mailing Address - Fax:956-795-1955
Practice Address - Street 1:6801 MCPHERSON AVE
Practice Address - Street 2:#332
Practice Address - City:LAREDO
Practice Address - State:TX
Practice Address - Zip Code:78041-6402
Practice Address - Country:US
Practice Address - Phone:956-795-1991
Practice Address - Fax:956-795-1955
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-01
Last Update Date:2015-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL0574208600000X, 207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX031206801Medicaid
TX031206801Medicaid
H21320Medicare UPIN