Individual ProviderCharles M DutchNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address6219 Irvington Blvd, Houston, TX 77022-5951(832) 380-2580(713) 677-4193PECOS EnrollmentBased on the most recent information from CMS, provider Charles M Dutch does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 12:57 PM.Profile DetailsProvider ID1417300146Provider TypeIndividualFull NameDutch, Charles MTitleMr.CredentialFNP-CGenderMaleSole ProprietorNoEnumeration Date7/18/2016Last Updated7/21/2022Contact InformationPractice LocationPractice Address6219 Irvington Blvd, Houston, TX 77022-5951Phone(832) 380-2580Fax(832) 380-2583Mailing LocationMailing Address9311 Aberdeen Lake Dr, Houston, TX 77095-4940Phone(713) 677-4193FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode363LF0000XPrimaryDescriptionNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersLicenseAP131447Texas