Healthcare Provider Details

I. General information

NPI: 1538340823
Provider Name (Legal Business Name): JOSHUA DALE STONER PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/15/2007
Last Update Date: 11/15/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

207 TILDEN
COTULLA TX
78014-2161
US

IV. Provider business mailing address

207 TILDEN
COTULLA TX
78014-2161
US

V. Phone/Fax

Practice location:
  • Phone: 830-879-2358
  • Fax: 830-879-3107
Mailing address:
  • Phone: 830-879-2358
  • Fax: 830-879-3107

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA05353
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: