Provider Demographics
NPI:1659464550
Name:SOPARKAR, CHARLES N (MD, PHD)
Entity Type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:N
Last Name:SOPARKAR
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3730 KIRBY DR
Mailing Address - Street 2:SUITE 900
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77098-3905
Mailing Address - Country:US
Mailing Address - Phone:713-795-0705
Mailing Address - Fax:713-807-0630
Practice Address - Street 1:3730 KIRBY DR
Practice Address - Street 2:SUITE 900
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77098-3905
Practice Address - Country:US
Practice Address - Phone:713-795-0705
Practice Address - Fax:713-807-0630
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2020-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ6247207WX0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207WX0200XAllopathic & Osteopathic PhysiciansOphthalmologyOphthalmic Plastic and Reconstructive Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1659464550OtherNPI
TX1235222167OtherGROUP NPI
TX135956402Medicaid
J6247OtherTX STATE LICENSE
TX135956402Medicaid
TX135956402Medicaid