Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0131X | Foot Surgery | 1748 | TX |
NPI | 1386683183 |
---|---|
Provider Name | Dr. Kent E Stahl |
First Address | Nederland, TX 77627-4246 |
Second Address | Nederland, TX 77627-4246 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/06/2006 |
Last Update Date | 28/03/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
V09374 | (02) | TX |