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General NPI Number Information
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NPI Number | 1649507930
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Entity Type | Organization
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Legal Business Name | DAVID STAGER, JR. M.D., P.A.
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Dates
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Enumeration Date | 11/08/2009
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Last Update Date | 11/08/2009
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Provider Practice Location Address
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Address Line | 3900 W 15TH ST STE 406
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City | PLANO
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State | TX
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Zip | 75075-7751
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Country | US
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Telephone | 972-758-0625
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Fax |
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Provider Business Mailing Address
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Address Line | 3900 W 15TH ST STE 406
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City | PLANO
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State | TX
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Zip | 75075-7751
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Country | US
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Telephone | 972-758-0625
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Fax |
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Authorized Official
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Title or Position | PRACTICE MANAGER
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Name | ELIZABETH ROLLINS
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Credential |
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Telephone | 972-758-0625
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | J1572
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License Number State | TX
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