Provider Demographics
NPI:1861814311
Name:TE, CHARISSE HANNE TAGAPULOT (MD)
Entity Type:Individual
Prefix:
First Name:CHARISSE HANNE
Middle Name:TAGAPULOT
Last Name:TE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4431 E HIGHWAY 287
Mailing Address - Street 2:
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:TX
Mailing Address - Zip Code:76065-4109
Mailing Address - Country:US
Mailing Address - Phone:469-800-9860
Mailing Address - Fax:
Practice Address - Street 1:4431 E HIGHWAY 287
Practice Address - Street 2:
Practice Address - City:MIDLOTHIAN
Practice Address - State:TX
Practice Address - Zip Code:76065-4109
Practice Address - Country:US
Practice Address - Phone:469-800-9860
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-16
Last Update Date:2023-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXT2275207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism