Healthcare Provider Details
I. General information
NPI: 1770288987
Provider Name (Legal Business Name): WILLIAM CHRISTOPHER STEHNACH DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 04/05/2023
Last Update Date: 01/06/2025
Certification Date: 01/06/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2200 BERGQUIST DR 2ND FLOOR, WING D
LACKLAND AIR FORCE BASE TX
78236-9911
US
IV. Provider business mailing address
714 MCCULLOUGH AVE APT 129
SAN ANTONIO TX
78215-1173
US
V. Phone/Fax
- Phone: 210-292-8218
- Fax:
- Phone: 618-670-7620
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 390200000X |
| Taxonomy | Student in an Organized Health Care Education/Training Program |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208D00000X |
| Taxonomy | General Practice Physician |
| License Number | 0102209070 |
| License Number State | VA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: