Provider Demographics
NPI:1942295522
Name:CHERCHES, IGOR MATTHEW (MD)
Entity Type:Individual
Prefix:
First Name:IGOR
Middle Name:MATTHEW
Last Name:CHERCHES
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 1:6655 TRAVIS ST STE 600
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-1341
Mailing Address - Country:US
Mailing Address - Phone:713-795-0074
Mailing Address - Fax:713-795-5203
Practice Address - Street 1:6655 TRAVIS ST STE 600
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-1341
Practice Address - Country:US
Practice Address - Phone:713-795-0074
Practice Address - Fax:713-795-5203
Is Sole Proprietor?:No
Enumeration Date:2005-09-20
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ10742084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX130010358OtherRAILROAD MEDICARE
TX118016802Medicaid
TX0687279OtherAETNA
TX118016802Medicaid
TX130010358OtherRAILROAD MEDICARE