Most Relevant Information
Provider Data
| NPI Number: | 1003641044 |
| Provider Name: | CHARLES BENSON SUDELL |
| Entity Type: | Individual |
| Taxonomy Code: | 171W00000X |
| Specialty: | Contractor |
| License Number: |
Most Important Dates
| Enumeration Date: | 09/06/2024 |
| Last Updated: | 09/06/2024 |
Provider Practice Location
836 COLONY DR
CROWLEY
TX
760362202
Practice Location Phone/Fax
| Phone: | 8178933369 |
| Fax: |
Provider Mailing Location
836 COLONY DR
CROWLEY
TX
760362202
Provider Mailing Phone/Fax
| Phone: | 8178933369 |
| Fax: |