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General NPI Number Information
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NPI Number | 1720305642
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Entity Type | Individual
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Provider Name | STEPHEN ANDREW MCNUTT M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/02/2010
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 1710 E SAUNDERS ST STE B675
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City | LAREDO
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State | TX
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Zip | 78041-5456
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Country | US
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Telephone | 956-401-6615
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Fax | 956-724-3613
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Provider Business Mailing Address
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Address Line | PO BOX 451496
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City | LAREDO
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State | TX
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Zip | 78045-0036
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Country | US
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Telephone | 443-695-3856
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Fax |
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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 | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 35.123366
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | Q7580
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License Number State | TX
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