Provider Demographics
NPI:1568655868
Name:CHARLES D WILKINS
Entity Type:Organization
Organization Name:CHARLES D WILKINS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ OPERATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:D
Authorized Official - Last Name:WILKINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-837-7348
Mailing Address - Street 1:305 W BAKER RD APT 913
Mailing Address - Street 2:
Mailing Address - City:BAYTOWN
Mailing Address - State:TX
Mailing Address - Zip Code:77521-2362
Mailing Address - Country:US
Mailing Address - Phone:281-837-7348
Mailing Address - Fax:
Practice Address - Street 1:305 W BAKER RD APT 913
Practice Address - Street 2:
Practice Address - City:BAYTOWN
Practice Address - State:TX
Practice Address - Zip Code:77521-2362
Practice Address - Country:US
Practice Address - Phone:832-893-6746
Practice Address - Fax:281-225-3854
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-21
Last Update Date:2008-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX32011771341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance