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General NPI Number Information
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NPI Number | 1285784298
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Entity Type | Individual
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Provider Name | MICHAEL TODD STAFFORD M.D.
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Gender | Male
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Dates
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Enumeration Date | 01/11/2007
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Last Update Date | 04/28/2016
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Provider Practice Location Address
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Address Line | 3560 DELAWARE ST SUITE 601-A
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City | BEAUMONT
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State | TX
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Zip | 77706-3067
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Country | US
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Telephone | 800-258-2016
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Fax | 409-924-9696
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Provider Business Mailing Address
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Address Line | 1515 COUNTRY SQUIRE DRIVE
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City | RICHMOND
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State | TX
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Zip | 77406-6642
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Country | US
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Telephone | 281-341-7676
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Fax | 409-924-9696
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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 | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | F7193
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License Number State | TX
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