Healthcare Provider Details

I. General information

NPI: 1790124386
Provider Name (Legal Business Name): ZACHARY S STINSON MD PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/18/2013
Last Update Date: 12/10/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

414 NAVARRO ST 1401
SAN ANTONIO TX
78205-2516
US

IV. Provider business mailing address

PO BOX 4346 DEPT 57
HOUSTON TX
77210-4346
US

V. Phone/Fax

Practice location:
  • Phone: 210-587-8120
  • Fax: 210-587-8139
Mailing address:
  • Phone: 210-733-0578
  • Fax: 210-587-8549

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: ZACHARY S STINSON
Title or Position: PRESIDENT
Credential: M.D.
Phone: 210-587-8120