Provider Demographics
NPI:1952502049
Name:MCBRIDE, CHARLES ALLAN (FNP-BC)
Entity Type:Individual
Prefix:
First Name:CHARLES
Middle Name:ALLAN
Last Name:MCBRIDE
Suffix:
Gender:M
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2925 HARGRAVE RD
Mailing Address - Street 2:
Mailing Address - City:HUFFMAN
Mailing Address - State:TX
Mailing Address - Zip Code:77336-3457
Mailing Address - Country:US
Mailing Address - Phone:281-360-7361
Mailing Address - Fax:
Practice Address - Street 1:910 LOUISIANA ST
Practice Address - Street 2:SUITE 17006C
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77002-4916
Practice Address - Country:US
Practice Address - Phone:713-241-1183
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-29
Last Update Date:2017-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP112032363LF0000X, 363LX0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LX0106XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerOccupational Health