Provider Demographics
NPI:1497180905
Name:CHARIS PHYSICIANS HOUSECALLS PLLC
Entity Type:Organization
Organization Name:CHARIS PHYSICIANS HOUSECALLS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:
Authorized Official - Last Name:ONWUELEZI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:469-366-9239
Mailing Address - Street 1:8206 SAWGRASS LN
Mailing Address - Street 2:
Mailing Address - City:ROWLETT
Mailing Address - State:TX
Mailing Address - Zip Code:75089-4809
Mailing Address - Country:US
Mailing Address - Phone:469-366-9239
Mailing Address - Fax:469-366-9249
Practice Address - Street 1:8206 SAWGRASS LN
Practice Address - Street 2:
Practice Address - City:ROWLETT
Practice Address - State:TX
Practice Address - Zip Code:75089-4809
Practice Address - Country:US
Practice Address - Phone:469-366-9239
Practice Address - Fax:469-366-9249
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-04
Last Update Date:2019-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary CareGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1497180905Medicaid