Healthcare Provider Details
I. General information
NPI: 1730051459
Provider Name (Legal Business Name): CORNERSTONE MEDICAL SPECIALISTS, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/22/2025
Last Update Date: 09/22/2025
Certification Date: 09/22/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3131 UNIVERSITY DR E
BRYAN TX
77802-3473
US
IV. Provider business mailing address
3120 SOUTHWEST FWY STE 101
HOUSTON TX
77098-4520
US
V. Phone/Fax
- Phone: 979-731-3100
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LA2100X |
| Taxonomy | Acute Care Nurse Practitioner |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
AESSA
BATES
Title or Position: NP
Credential: NP
Phone: 281-795-5113