| Doctor Name: | CHARLES RENE |
| NPI Number: | 1396755013 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.D. |
| License Number: | 014495 |
| Business Practice Address: | 3909 Lapalco Blvd Ste 200 Harvey, LA - 700582302 |
| Business Phone Number: | 5043496216 |
| Business Fax Number: | |
| Mailing Address: | 149 W Lakeview Dr, LA PLACE |
| State: | LA |
| Postal Code: | 700682427 |
| Phone Number: | 9856517740 |
| Fax Number: | |
| NPI Enumeration Date: | 08/08/2006 |
| NPI Last Update Date: | 10/05/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 174400000X |
| License Number: | 014495 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | LA |
| Taxonomy Type: | Other Service Providers |
| Taxonomy Classification: | Specialist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |