Healthcare Provider Details
I. General information
NPI: 1275888679
Provider Name (Legal Business Name): STEPHEN DINGER DO PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/23/2012
Last Update Date: 09/20/2024
Certification Date: 09/20/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
17766 VERDE PARKWAY, SUITE 260
SCHERTZ TX
78154
US
IV. Provider business mailing address
5000 SCHERTZ PKWY STE 400
SCHERTZ TX
78154-1457
US
V. Phone/Fax
- Phone: 210-495-7246
- Fax:
- Phone: 210-495-7246
- Fax: 210-495-7245
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2081P2900X |
| Taxonomy | Pain Medicine (Physical Medicine & Rehabilitation) Physician |
| License Number | M1636 |
| License Number State | TX |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208100000X |
| Taxonomy | Physical Medicine & Rehabilitation Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
STEPHEN
W
DINGER
Title or Position: PRESIDENT
Credential: DO
Phone: 210-495-7246