Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111N00000X | Chiropractor | 24763 | CA |
N | 111NX0100X | Occupational Health | 6915 | TX |
NPI | 1366553000 |
---|---|
Provider Name | Dr. Howard Lee Stich III |
First Address | San Antonio, TX 78254-2046 |
Second Address | San Antonio, TX 78229-5640 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 31/08/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
8S7694 | BCBS (01) | TX |