Provider Demographics
NPI:1639140544
Name:VOLK, CHARLES THOMAS (MD)
Entity Type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:THOMAS
Last Name:VOLK
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 1:6133 PARKWAY
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78414-2459
Mailing Address - Country:US
Mailing Address - Phone:361-881-8333
Mailing Address - Fax:361-884-8302
Practice Address - Street 1:6133 PARKWAY
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78414-2459
Practice Address - Country:US
Practice Address - Phone:361-881-8333
Practice Address - Fax:361-884-8302
Is Sole Proprietor?:No
Enumeration Date:2006-01-30
Last Update Date:2010-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF7271208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX84211401Medicaid
TXB27358Medicare UPIN
TX00N501Medicare ID - Type Unspecified