Provider Demographics
NPI:1508087438
Name:DENDY, CHARLIE FRANK (DO)
Entity Type:Individual
Prefix:DR
First Name:CHARLIE
Middle Name:FRANK
Last Name:DENDY
Suffix:
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 1:500 MEDICAL CENTER BLVD
Mailing Address - Street 2:STE 340
Mailing Address - City:CONROE
Mailing Address - State:TX
Mailing Address - Zip Code:77304-2889
Mailing Address - Country:US
Mailing Address - Phone:281-249-2260
Mailing Address - Fax:
Practice Address - Street 1:500 MEDICAL CENTER BLVD
Practice Address - Street 2:STE 340
Practice Address - City:CONROE
Practice Address - State:TX
Practice Address - Zip Code:77304-2889
Practice Address - Country:US
Practice Address - Phone:281-249-2260
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-01
Last Update Date:2022-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL7354208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8K0819Medicare PIN