Provider Demographics
NPI:1629006051
Name:MCCASH, CHARLES STEWART (MD)
Entity Type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:STEWART
Last Name:MCCASH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1314 E SONTERRA
Mailing Address - Street 2:STE 5201
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78258-4290
Mailing Address - Country:US
Mailing Address - Phone:210-340-6633
Mailing Address - Fax:210-340-6390
Practice Address - Street 1:1314 E SONTERRA
Practice Address - Street 2:STE 5201
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78258-4290
Practice Address - Country:US
Practice Address - Phone:210-340-6633
Practice Address - Fax:210-340-6390
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2013-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ4335174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX120659103Medicaid
TXG47255Medicare UPIN
8A2082Medicare PIN