Active NPI 1588695654 Individual Practitioner Male Practitioner

Dr. Charles L Secrest , MD

Urology • Fort Worth, TX

✓ Accepts Medicare Assignment

Professional Overview & Biography Verified Profile Summary

Dr. Charles Secrest, MD is a certified Urology practicing in Fort Worth, TX. With approximately 40 years of clinical experience since graduating from University Of Mississippi School Of Medicine in 1986, Dr. Secrest delivers high-quality medical care to the local community at 1101 6TH AVE STE 110.

Dr. Secrest is affiliated with Healthtexas Provider Network and accepts Medicare assignment.

Frequently performed procedures and clinical services include injection, onabotulinumtoxina, 1 unit, automated urinalysis test, established patient outpatient office visit. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

1101 6th Ave Ste 110

Fort Worth, TX 76104

Telephone 8179128570

Medicare Profile & Education

Medical School

University Of Mississippi School Of Medicine

Graduation Year

1986

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Urology in Fort Worth, TX

Senior Veteran Specialist (>20 Yrs)

Practitioner Clinical Experience

40 Yrs +16.3 yrs vs City Avg

City Avg: 23.7 Yrs

State Avg: 25.2 Yrs

Regional Practice Density

45 Specialists

Practicing in Fort Worth, TX (1027 Statewide)

Telehealth Adoption Rate

37.8% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

77.6% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Secrest (40 Years) 40 Yrs

Fort Worth Specialty Average (23.7 Years) 23.7 Yrs

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2024)

Reporting Year:

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
J0585 Injection, onabotulinumtoxina, 1 unit	3,400	12	$16.78	$6.25
81003 Automated urinalysis test	418	184	$20.00	$2.20
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	125	97	$238.22	$126.14
52000 Diagnostic exam of bladder and urethra using an endoscope	112	101	$845.36	$230.65
99213 Established patient office or other outpatient visit, typically 15 minutes	81	70	$168.44	$89.41
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	76	76	$309.53	$163.34
51741 Electronic assessment of bladder emptying	62	53	$175.00	$7.23
76775 Limited ultrasound scan behind abdominal cavity	42	39	$216.00	$58.57
51784 Non-needle measurement and recording of electrical activity of muscles at bladder and bowel openings	37	36	$427.00	$31.49
51797 Insertion of device into abdomen with pressure and urine flow rate study	27	27	$685.55	$184.76
51728 Complex measurement of pressure of urine flow in bladder with voiding pressure studies	26	26	$1283.70	$337.39
J1580 Injection, garamycin, gentamicin, up to 80 mg	19	11	$25.81	$2.44
57288 Creation of sling around bladder canal (urethra) to control leakage	17	17	$3225.00	$535.69
52287 Exam with injections of chemical for destruction of bladder using an endoscope	17	13	$1363.22	$361.03
57267 Placement of artificial material for pelvic floor defect	15	15	$848.61	$243.05
93980 Ultrasound scan of penile arterial inflow and venous outflow	15	15	$424.24	$115.08
57282 Repair of pelvic ligaments through vagina	14	14	$2373.17	$413.13
54235 Injection procedure to induce erection	11	11	$299.53	$84.91
51102 Aspiration of bladder with insertion of bladder tube to skin surface	11	11	$855.00	$100.46

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
81003 Automated urinalysis test	387	176	$20.00	$2.20
52000 Diagnostic exam of bladder and urethra using an endoscope	99	89	$845.36	$231.65
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	73	63	$238.22	$125.95
51741 Electronic assessment of bladder emptying	70	58	$175.00	$7.09
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	64	64	$309.53	$161.85
99213 Established patient office or other outpatient visit, typically 15 minutes	53	48	$168.44	$88.10
76775 Limited ultrasound scan behind abdominal cavity	41	37	$216.00	$58.78
51797 Insertion of device into abdomen with pressure and urine flow rate study	39	37	$685.55	$191.68
51784 Non-needle measurement and recording of electrical activity of muscles at bladder and bowel openings	38	36	$427.00	$31.57
51728 Complex measurement of pressure of urine flow in bladder with voiding pressure studies	35	34	$1283.70	$352.30
36415 Insertion of needle into vein for collection of blood sample	32	24	$17.00	$8.40
51798 Ultrasound measurement of bladder capacity after voiding	25	25	$47.00	$10.54
57288 Creation of sling around bladder canal (urethra) to control leakage	14	14	$3225.00	$670.64
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	14	14	$207.18	$109.98
51710 Complicated change of bladder tube	13	11	$490.00	$129.29
57240 Repair of herniated bladder into vaginal wall	12	12	$2098.09	$351.76
76857 Limited ultrasound scan of pelvis	11	11	$207.00	$48.64
57282 Repair of pelvic ligaments through vagina	11	11	$2373.17	$411.72

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
J0585 Injection, onabotulinumtoxina, 1 unit	2,250	12	$18.00	$6.14
81003 Automated urinalysis test	533	208	$20.00	$2.22
52000 Diagnostic exam of bladder and urethra using an endoscope	123	109	$634.89	$229.87
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	107	107	$289.66	$164.16
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	86	78	$192.21	$125.87
99213 Established patient office or other outpatient visit, typically 15 minutes	82	70	$128.21	$90.01
51741 Electronic assessment of bladder emptying	82	72	$175.00	$7.24
76775 Limited ultrasound scan behind abdominal cavity	67	66	$216.00	$58.64
51728 Complex measurement of pressure of urine flow in bladder with voiding pressure studies	57	57	$898.65	$362.98
51797 Insertion of device into abdomen with pressure and urine flow rate study	56	56	$621.10	$201.21
51784 Non-needle measurement and recording of electrical activity of muscles at bladder and bowel openings	46	46	$427.00	$32.63
93980 Ultrasound scan of penile arterial inflow and venous outflow	18	18	$354.75	$117.00
57288 Creation of sling around bladder canal (urethra) to control leakage	18	18	$3225.00	$651.76
76857 Limited ultrasound scan of pelvis	16	16	$207.00	$48.42
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	16	16	$199.57	$101.55
51710 Complicated change of bladder tube	16	14	$490.00	$136.37
51798 Ultrasound measurement of bladder capacity after voiding	14	14	$47.00	$10.06
54235 Injection procedure to induce erection	14	14	$214.15	$83.67
52287 Exam with injections of chemical for destruction of bladder using an endoscope	14	13	$839.30	$399.22
57282 Repair of pelvic ligaments through vagina	11	11	$1385.74	$342.61

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
J0585 Injection, onabotulinumtoxina, 1 unit	2,800	15	$18.00	$6.07
81003 Automated urinalysis test	440	165	$20.00	$2.25
52000 Diagnostic exam of bladder and urethra using an endoscope	98	89	$567.00	$200.96
99213 Established patient office or other outpatient visit, typically 15 minutes	89	69	$105.00	$91.37
51741 Electronic assessment of bladder emptying	60	52	$175.00	$7.40
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	55	55	$280.00	$162.48
51797 Insertion of device into abdomen with pressure and urine flow rate study	52	49	$593.00	$191.28
51728 Complex measurement of pressure of urine flow in bladder with voiding pressure studies	52	49	$735.00	$378.69
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	49	43	$170.00	$127.89
76775 Limited ultrasound scan behind abdominal cavity	40	38	$216.00	$58.48
51784 Non-needle measurement and recording of electrical activity of muscles at bladder and bowel openings	39	39	$427.00	$33.22
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	33	29	$80.00	$56.31
99442 Telephone medical discussion with physician, 11-20 minutes	28	28	$128.00	$89.81
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	28	28	$195.00	$111.97
76857 Limited ultrasound scan of pelvis	24	24	$207.00	$48.50
52287 Exam with injections of chemical for destruction of bladder using an endoscope	19	16	$799.00	$392.28
51102 Aspiration of bladder with insertion of bladder tube to skin surface	16	16	$855.00	$98.79
99441 Telephone medical discussion with physician, 5-10 minutes	11	11	$78.00	$54.45

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
J0585 Injection, onabotulinumtoxina, 1 unit	1,750	13	$18.00	$6.08
81003 Automated urinalysis test	292	136	$20.00	$2.24
52000 Diagnostic exam of bladder and urethra using an endoscope	90	74	$567.00	$200.41
99213 Established patient office or other outpatient visit, typically 15 minutes	87	67	$105.00	$75.78
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	52	52	$280.00	$161.30
51741 Electronic assessment of bladder emptying	50	38	$175.00	$8.03
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	46	39	$80.00	$45.92
76775 Limited ultrasound scan behind abdominal cavity	44	39	$216.00	$59.98
51798 Ultrasound measurement of bladder capacity after voiding	43	37	$47.00	$10.29
51728 Complex measurement of pressure of urine flow in bladder with voiding pressure studies	41	40	$735.00	$356.49
51797 Insertion of device into abdomen with pressure and urine flow rate study	40	39	$593.00	$166.26
J1580 Injection, garamycin, gentamicin, up to 80 mg	38	13	$20.00	$1.87
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	37	30	$170.00	$109.79
51784 Non-needle measurement and recording of electrical activity of muscles at bladder and bowel openings	32	32	$427.00	$34.45
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	31	31	$195.00	$108.95
76857 Limited ultrasound scan of pelvis	26	23	$207.00	$49.21
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	16	12	$65.00	$14.40
52287 Exam with injections of chemical for destruction of bladder using an endoscope	15	14	$799.00	$354.43
99202 New patient office or other outpatient visit, typically 20 minutes	12	12	$130.00	$76.64
99441 Telephone medical discussion with physician, 5-10 minutes	12	12	$68.63	$45.99

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
J0585 Injection, onabotulinumtoxina, 1 unit	1,801	12	$15.83	$6.03
81002 Urinalysis, manual test	211	131	$19.95	$3.40
51798 Ultrasound measurement of bladder capacity after voiding	198	132	$53.55	$12.18
99213 Established patient office or other outpatient visit, typically 15 minutes	99	84	$145.56	$72.65
81003 Automated urinalysis test	88	51	$20.00	$2.42
52000 Diagnostic exam of bladder and urethra using an endoscope	86	82	$512.12	$161.07
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	48	48	$228.92	$104.12
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	39	35	$208.36	$106.97
51741 Electronic assessment of bladder emptying	39	32	$198.85	$7.75
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	33	33	$298.03	$162.94
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	30	27	$94.40	$43.73
51726 Complex measurement of pressure of urine flow in bladder	18	18	$812.28	$193.52
51784 Non-needle measurement and recording of electrical activity of muscles at bladder and bowel openings	16	16	$402.63	$28.08
99202 New patient office or other outpatient visit, typically 20 minutes	13	13	$164.00	$73.97
52287 Exam with injections of chemical for destruction of bladder using an endoscope	12	11	$744.33	$332.44
51797 Insertion of device into abdomen with pressure and urine flow rate study	11	11	$500.82	$127.74

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
J0585 Injection, onabotulinumtoxina, 1 unit	6,749	36	$10.49	$5.81
81003 Automated urinalysis test	468	286	$113.00	$2.71
81000 Manual urinalysis test with examination using microscope, non-automated	295	177	$25.00	$3.89
99213 Established patient office or other outpatient visit, typically 15 minutes	266	207	$142.19	$69.19
51798 Ultrasound measurement of bladder capacity after voiding	241	173	$247.59	$14.84
52000 Diagnostic exam of bladder and urethra using an endoscope	193	184	$473.50	$139.81
51741 Electronic assessment of bladder emptying	134	121	$177.76	$8.06
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	130	115	$176.52	$103.25
51797 Insertion of device into abdomen with pressure and urine flow rate study	100	99	$573.30	$108.12
51784 Non-needle measurement and recording of electrical activity of muscles at bladder and bowel openings	100	100	$447.64	$33.33
51600 Injection procedure for X-ray imaging of the bladder or during voiding	96	90	$666.77	$113.75
87088 Bacterial urine culture	94	69	$45.00	$9.61
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	88	88	$291.35	$157.79
51728 Complex measurement of pressure of urine flow in bladder with voiding pressure studies	80	80	$663.13	$302.75
64566 Implantation of lower leg neurostimulator electrode, accessed through the skin	71	14	$263.00	$123.51
74455 Review by radiologist of urinary bladder and urethra images with contrast and after passing urine	57	54	$307.81	$74.76
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	57	57	$192.19	$103.80
57160 Fitting and insertion of vaginal support device	54	28	$201.50	$71.24
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	54	53	$78.91	$42.15
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	48	28	$54.25	$19.61
J1580 Injection, garamycin, gentamicin, up to 80 mg	46	15	$9.57	$1.41
51725 Simple measurement of pressure of urine flow in bladder	44	34	$614.95	$178.45
52287 Exam with injections of chemical for destruction of bladder using an endoscope	43	37	$951.91	$288.51
76000 Imaging guidance for procedure, 60 minutes or less	43	43	$275.00	$44.13
87184 Evaluation of antimicrobial drug (antibiotic, antifungal, antiviral)	40	36	$37.00	$8.34
87086 Bacterial colony count, urine	40	36	$46.00	$9.76
74430 Radiological supervision and interpretation X-ray of urinary bladder, minimum of 3 views	39	35	$201.05	$35.91
76770 Complete ultrasound scan behind abdominal cavity	39	39	$537.36	$103.29
81002 Urinalysis, manual test	38	36	$20.00	$3.41
99211 Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional	36	20	$44.00	$20.63
57288 Creation of sling around bladder canal (urethra) to control leakage	33	33	$3129.33	$567.90
51715 Injection of implant material beneath lining of bladder and/or urethra using an endoscope	30	28	$968.00	$279.73
57282 Repair of pelvic ligaments through vagina	24	24	$2549.42	$239.37
51729 Complex measurement of pressure of urine flow in bladder with urethra pressure and voiding pressure studies	24	24	$733.00	$329.11
51701 Insertion of temporary bladder tube	22	20	$153.41	$45.76
A4562 Pessary, reusable, non rubber, any type	18	12	$118.00	$56.69
51705 Removal of skin suture with change of bladder tube	17	11	$226.18	$83.32
74176 Ct scan of abdomen and pelvis without contrast	17	15	$900.00	$106.28
51702 Simple insertion of temporary bladder tube	17	11	$205.00	$61.84
36415 Insertion of needle into vein for collection of blood sample	17	17	$20.00	$2.94
93980 Ultrasound scan of penile arterial inflow and venous outflow	15	15	$354.40	$121.86
51700 Simple bladder irrigation and/or instillation	14	11	$290.14	$55.88
54235 Injection procedure to induce erection	13	13	$185.77	$89.42
84153 Psa (prostate specific antigen) measurement, total	13	13	$100.00	$22.26
57240 Repair of herniated bladder into vaginal wall	12	12	$1782.42	$323.02
P9612 Catheterization for collection of specimen, single patient, all places of service	12	11	$50.00	$2.94
52276 Incision of the bladder canal (urethra) using an endoscope	11	11	$1888.55	$243.99

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
J1071 Injection, testosterone cypionate, 1 mg	14,101	14	$0.80	$0.02
J0585 Injection, onabotulinumtoxina, 1 unit	5,050	31	$12.57	$5.89
81002 Urinalysis, manual test	814	432	$9.22	$3.42
51798 Ultrasound measurement of bladder capacity after voiding	501	359	$51.57	$17.89
81003 Automated urinalysis test	340	237	$112.10	$3.02
52000 Diagnostic exam of bladder and urethra using an endoscope	295	278	$457.89	$143.73
99213 Established patient office or other outpatient visit, typically 15 minutes	272	232	$201.41	$69.39
51741 Electronic assessment of bladder emptying	241	211	$82.78	$8.36
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	219	188	$106.02	$41.44
64566 Implantation of lower leg neurostimulator electrode, accessed through the skin	200	24	$327.48	$119.43
J0696 Injection, ceftriaxone sodium, per 250 mg	178	35	$20.48	$0.63
51728 Complex measurement of pressure of urine flow in bladder with voiding pressure studies	176	166	$827.05	$293.54
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	165	69	$66.93	$23.82
51784 Non-needle measurement and recording of electrical activity of muscles at bladder and bowel openings	154	154	$278.08	$32.94
57160 Fitting and insertion of vaginal support device	153	37	$203.10	$72.89
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	137	137	$274.39	$101.83
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	111	111	$428.48	$156.14
J1580 Injection, garamycin, gentamicin, up to 80 mg	102	32	$10.35	$1.51
51600 Injection procedure for X-ray imaging of the bladder or during voiding	99	94	$364.98	$92.25
76770 Complete ultrasound scan behind abdominal cavity	99	95	$334.82	$107.36
36415 Insertion of needle into vein for collection of blood sample	84	79	$10.62	$2.91
51725 Simple measurement of pressure of urine flow in bladder	82	70	$548.29	$177.77
L8606 Injectable bulking agent, synthetic implant, urinary tract, 1 ml syringe, includes shipping and necessary supplies	61	20	$481.00	$207.08
51705 Removal of skin suture with change of bladder tube	58	20	$256.28	$85.49
74430 Radiological supervision and interpretation X-ray of urinary bladder, minimum of 3 views	58	56	$151.79	$35.78
P9612 Catheterization for collection of specimen, single patient, all places of service	56	50	$19.50	$2.87
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	51	50	$282.04	$102.89
57288 Creation of sling around bladder canal (urethra) to control leakage	41	41	$2421.95	$559.01
52287 Exam with injections of chemical for destruction of bladder using an endoscope	36	31	$789.86	$285.56
51701 Insertion of temporary bladder tube	35	30	$138.60	$45.41
52601 Electro-removal of prostate through bladder canal (urethra) with control of bleeding using an endoscope	26	26	$2496.77	$832.69
99202 New patient office or other outpatient visit, typically 20 minutes	24	24	$171.17	$71.41
99211 Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional	23	22	$54.26	$19.11
51715 Injection of implant material beneath lining of bladder and/or urethra using an endoscope	22	20	$816.09	$261.33
57240 Repair of herniated bladder into vaginal wall	22	21	$1835.55	$329.90
93980 Ultrasound scan of penile arterial inflow and venous outflow	18	18	$380.89	$115.98
57282 Repair of pelvic ligaments through vagina	18	17	$1884.44	$225.62
54235 Injection procedure to induce erection	18	18	$264.89	$83.75
74455 Review by radiologist of urinary bladder and urethra images with contrast and after passing urine	16	12	$202.25	$76.50
52332 Insertion of stent in urinary duct (ureter) using an endoscope	16	14	$1261.50	$136.87
51702 Simple insertion of temporary bladder tube	14	11	$185.93	$59.80
A4562 Pessary, reusable, non rubber, any type	14	13	$124.86	$56.11

Medical Specialties & State Licenses

Urology Primary Specialty

NUCC Taxonomy Code: 208800000X

State License TX H2964

A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures.

Specialist

NUCC Taxonomy Code: 174400000X

State License MS B29973

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.

Urology

NUCC Taxonomy Code: 208800000X

State License MS 11417

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID

1694304 (LA)

Hospital & Practice Group Affiliations

Healthtexas Provider Network

5408 Colleyville Blvd, Colleyville, TX 760345833

Phone: 8174989920

Healthtexas Provider Network

1400 8th Ave, Fort Worth, TX 761044110

Healthtexas Provider Network

1101 6th Ave, Fort Worth, TX 761044306

Phone: 8179128360

Healthtexas Provider Network

4001 Worth St, Dallas, TX 752461608

Secondary Practice Locations

703 E Marshall Ave, Suite 5007

Longview, TX 756015500

Phone: 9033154455

700 Olympic Plaza Cir Ste 700

Tyler, TX 75701

Phone: 9032623900

911 S Beckham Ave

Tyler, TX 757011907

Phone: 9032623900

1101 6th Ave Ste 110

Fort Worth, TX 76104

Phone: 8179128570

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

2 Associated Practitioners

Osamah Hasan

Urology

NPI 1386205011

Shawna Rubalcaba , FNP

Nurse Practitioner - Family

NPI 1609418045

Family Nurse Practitioner

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

10 Historical Events

📍

Updated Practice Location June 28, 2019

Registered at 1101 6TH AVE STE 110, FORT WORTH, TX 76104 (Tel: 8179128570)

📍

Updated Business Mailing Address June 28, 2019

Registered at 1101 6TH AVE STE 110, FORT WORTH, TX 761044306 (Tel: 8179128570)

📍

Updated Practice Location June 22, 2018

Registered at 700 OLYMPIC PLAZA CIR STE 700, TYLER, TX 75701 (Tel: 9032623900)

📍

Updated Business Mailing Address June 22, 2018

Registered at 700 OLYMPIC PLAZA CIR STE 700, TYLER, TX 757011954 (Tel: 9032623900)

✅

NPI Profile Active September 23, 2013

NPI status registered as active in NPPES database

📍

Updated Practice Location September 23, 2013

Registered at 703 E MARSHALL AVE, SUITE 5007, LONGVIEW, TX 756015500 (Tel: 9033154455)

📍

Updated Business Mailing Address September 23, 2013

Registered at PO BOX 731218, DALLAS, TX 753731218 (Tel: 9033154455)

👤

Provider Name / Credentials Updated September 23, 2013

Recorded as CHARLES SECREST, MD

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) September 23, 2013

Specialist (License #B29973 in MS)

🟢

Initial NPI Registration & Enumeration July 06, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1588695654

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: July 06, 2006

Last Update: June 28, 2019

Sole Proprietor: No

Update or Correct Profile

Mailing Address

1101 6th Ave Ste 110

Fort Worth, TX 761044306

Phone: 8179128570

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).

⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.