Provider Demographics
NPI:1629060405
Name:CHARNOV, JEFFREY HAL (MD)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:HAL
Last Name:CHARNOV
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 1:915 GESSNER RD.
Mailing Address - Street 2:SUITE 970
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77024
Mailing Address - Country:US
Mailing Address - Phone:713-932-0770
Mailing Address - Fax:713-932-8595
Practice Address - Street 1:915 GESSNER RD.
Practice Address - Street 2:SUITE 970
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77024-2663
Practice Address - Country:US
Practice Address - Phone:713-932-0770
Practice Address - Fax:713-932-8595
Is Sole Proprietor?:No
Enumeration Date:2005-08-18
Last Update Date:2021-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH6111208VP0000X, 208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
No208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX123129201OtherTPI
TX123129201Medicaid
TX1871715649OtherNPI
TX085283201OtherTPI
TX085283201Medicaid
TX1629060405OtherNPI
TX1629060405OtherNPI
TX8F8453Medicare PIN