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General NPI Number Information
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NPI Number | 1033329644
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Entity Type | Individual
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Provider Name | CARRIE ANN STOGNER L.A.T.
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Gender | Female
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Dates
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Enumeration Date | 05/23/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 600 W NORRIS ST
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City | EL CAMPO
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State | TX
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Zip | 77437-2430
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Country | US
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Telephone | 979-578-1934
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Fax | 979-543-5565
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Provider Business Mailing Address
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Address Line | 703 FARLEY ST
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City | EL CAMPO
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State | TX
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Zip | 77437-3823
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Country | US
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Telephone | 979-543-4057
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Fax | 979-543-5565
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171W00000X
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Taxonomy Name | Contractor
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License Number | AT1221
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License Number State | TX
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