Healthcare Provider Details

I. General information

NPI: 1568414530
Provider Name (Legal Business Name): HARRY MEYER STELLMAN IV M. D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/17/2006
Last Update Date: 01/25/2023
Certification Date: 01/25/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

255 W LEBANON STE 104
FRISCO TX
75036-3412
US

IV. Provider business mailing address

PO BOX 733784
DALLAS TX
75373-3784
US

V. Phone/Fax

Practice location:
  • Phone: 972-370-2425
  • Fax: 972-370-2591
Mailing address:
  • Phone: 682-885-6163
  • Fax: 682-885-3113

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberL4137
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: