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General NPI Number Information
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NPI Number | 1639378235
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Entity Type | Organization
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Legal Business Name | TAMARA STOUT, M.D., P.A.
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Dates
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Enumeration Date | 07/13/2007
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Last Update Date | 06/18/2008
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Provider Practice Location Address
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Address Line | 707 S FRY RD SUITE 280
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City | KATY
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State | TX
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Zip | 77450-2256
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Country | US
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Telephone | 281-398-5360
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Fax | 281-398-5364
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Provider Business Mailing Address
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Address Line | 707 S FRY RD SUITE 280
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City | KATY
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State | TX
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Zip | 77450-2256
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Country | US
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Telephone | 281-398-5360
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Fax | 281-398-5364
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. TAMARA ALUMBAUGH STOUT
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Credential | M.D.
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Telephone | 281-398-5360
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | M0935
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License Number State | TX
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