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Contact Information

CHARLES E MANGUM, MD
7501 LAKEVIEW PKWY
STE 160
ROWLETT, TX75088-9322
 Phone: 972-526-0340
 Fax: 972-996-1857
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Anatomic Pathology & Clinical Pathology

207ZP0102X 22 Physician/Pathology
Indicates primary specialty

NPI Profile & details for CHARLES E MANGUM · (Male)

NPI Number 1982666210
Status Active
Credentials MD
Entity Individual
Enumeration date 04/03/2006
Last updated 03/20/2012 - About 14 years ago
Sole proprietor 1 Yes
Identifiers
  • TX License # J3349
  • TX Medicaid 117454204
  • TX Medicaid 117454205
  • TX Other 8BX668 BLUE CROSS BLUE SHIELD
  • TX Other 8U7632 BLUE CROSS BLUE SHIELD
  • TX Other P00295238 RAILROAD MEDICARE
Hospital affiliation(s)
  • CENTENNIAL MEDICAL CENTER - (Acute Care)
    12505 LEBANON ROAD
    FRISCO, TX 75035
  • DOCTORS HOSPITAL - (Acute Care)
    9440 POPPY DR
    DALLAS, TX 75218
  • LAKE POINTE MEDICAL CENTER - (Acute Care)
    6800 SCENIC DR
    ROWLETT, TX 75088
  • TEXAS HEALTH PRESBYTERIAN HOSPITAL ROCKWALL - (Acute Care)
    3150 HORIZON ROAD
    ROCKWALL, TX 75032
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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