Provider Demographics
NPI:1780940619
Name:CHARLES H DUKES M.D., P.A.
Entity type:Organization
Organization Name:CHARLES H DUKES M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHIATRIST/PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:HUSTON
Authorized Official - Last Name:DUKES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:719-439-7003
Mailing Address - Street 1:4300 MACARTHUR AVE STE 260
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75209-6628
Mailing Address - Country:US
Mailing Address - Phone:719-439-7003
Mailing Address - Fax:
Practice Address - Street 1:4300 MACARTHUR AVE STE 260
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75209-6628
Practice Address - Country:US
Practice Address - Phone:719-439-7003
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-04
Last Update Date:2012-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP12932084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty