Charles B Russey

NPI #1477651826 in Southlake, Texas

Provider Information

NPI Number
1477651826
Entity Type
Organization
Organization Name
Charles B Russey
Primary Specialty
Family Medicine
Enumeration Date
Sep 20, 2006
Last Updated
Aug 22, 2020

Practice Location

Address
480 W SOUTHLAKE BLVD
Address 2
SUITE 115
State
Texas
ZIP Code
76092
Phone
(817) 416-2221

Authorized Official

Name
MS. HEATHER RENEE HARDIN
Title
OFFICE MANAGER
Phone
(814) 162-2221

Specialties & Taxonomy Codes

Specialty
Family Medicine

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