CHARLES MARK RUSSELL

SAN ANTONIO, TX
NPI1043218720
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy363AM0700X Physician Assistant Medical
(Licence: TX  PA00353)
Enumeration Date2005-07-07
Last Update Date2016-10-18
Business Address
CHARLES MARK RUSSELL PA
6157 NW LOOP 410 STE. 124
SAN ANTONIO, TX 78238-3302
Phone number: 210-523-1411
Mailing Address
CHARLES MARK RUSSELL PA
6157 NW LOOP 410 STE. 124
SAN ANTONIO, TX 78238-3302
Phone number: 210-523-1411
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