Provider Demographics
NPI:1962468835
Name:SAFELY, CHARLES ARTHUR (MD)
Entity Type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:ARTHUR
Last Name:SAFELY
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 1:1252 HARWOOD RD
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:TX
Mailing Address - Zip Code:76021-4244
Mailing Address - Country:US
Mailing Address - Phone:817-284-1496
Mailing Address - Fax:817-284-3923
Practice Address - Street 1:1252 HARWOOD RD
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:TX
Practice Address - Zip Code:76021-4244
Practice Address - Country:US
Practice Address - Phone:817-284-1496
Practice Address - Fax:817-284-3923
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-21
Last Update Date:2023-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH9565207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00N93LOtherBLUE CROSS PROVIDER NUMBE
TX099605001Medicaid
TX45D0928369OtherCLIA NUMBER
TX10028069OtherAMERIGROUP PROVIDER NUMBE
TX45D0928369OtherCLIA NUMBER
TX00N93LOtherBLUE CROSS PROVIDER NUMBE