Provider Demographics
NPI:1609015429
Name:MCCABE, CHARLES (HIS)
Entity Type:Individual
Prefix:
First Name:CHARLES
Middle Name:
Last Name:MCCABE
Suffix:
Gender:M
Credentials:HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9595 SIX PINES DR
Mailing Address - Street 2:STE 8210
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77380-1531
Mailing Address - Country:US
Mailing Address - Phone:281-772-4920
Mailing Address - Fax:832-631-6040
Practice Address - Street 1:9595 SIX PINES DR
Practice Address - Street 2:STE 8210
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77380-1531
Practice Address - Country:US
Practice Address - Phone:281-772-4920
Practice Address - Fax:832-631-6040
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-18
Last Update Date:2012-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX50623237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist