Provider Demographics
NPI:1811498959
Name:MCGEE, CHARLES W (NP)
Entity type:Individual
Prefix:MR
First Name:CHARLES
Middle Name:W
Last Name:MCGEE
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 AVENUE A
Mailing Address - Street 2:
Mailing Address - City:WHARTON
Mailing Address - State:TX
Mailing Address - Zip Code:77488-3909
Mailing Address - Country:US
Mailing Address - Phone:409-338-9265
Mailing Address - Fax:
Practice Address - Street 1:416 N ALABAMA RD
Practice Address - Street 2:
Practice Address - City:WHARTON
Practice Address - State:TX
Practice Address - Zip Code:77488-4210
Practice Address - Country:US
Practice Address - Phone:979-282-6151
Practice Address - Fax:832-930-4586
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-23
Last Update Date:2018-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP136238363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXAP136238OtherADVANCE PRACTICE NURSE