Provider Demographics
NPI:1770582322
Name:STARGHILL, CHARLOTTE THERESA (MD)
Entity type:Individual
Prefix:DR
First Name:CHARLOTTE
Middle Name:THERESA
Last Name:STARGHILL
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:PO BOX 226403
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75222-6403
Mailing Address - Country:US
Mailing Address - Phone:972-283-1951
Mailing Address - Fax:972-283-1988
Practice Address - Street 1:7010 AMERICAN WAY
Practice Address - Street 2:SUITE D
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75237-2499
Practice Address - Country:US
Practice Address - Phone:972-283-1951
Practice Address - Fax:972-283-1988
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-16
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ2354207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX139456117Medicaid
TXOO30GXOtherBLUE CROSS BLUE SHIELD
TX139456120Medicaid
TX139456118Medicaid
TX139456118Medicaid
TX139456120Medicaid
TX139456118Medicaid