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General NPI Number Information
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NPI Number | 1811063647
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Entity Type | Individual
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Provider Name | RICHARD A. STOLZE PA-C
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Gender | Male
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Dates
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Enumeration Date | 11/24/2006
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Last Update Date | 10/17/2023
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Provider Practice Location Address
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Address Line | 140 HILLCREST MEDICAL BLVD STE 2
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City | WACO
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State | TX
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Zip | 76712-8897
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Country | US
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Telephone | 254-741-1400
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Fax | 254-741-1428
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Provider Business Mailing Address
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Address Line | PO BOX 848491
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City | DALLAS
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State | TX
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Zip | 75284-8491
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Country | US
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Telephone | 254-202-9330
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Fax | 254-202-9349
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 1591
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 085005428
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License Number State | IL
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Taxonomy #3
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Taxonomy Code | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number | PA 9106393
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License Number State | FL
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Taxonomy #4
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Taxonomy Code | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number | PA0000001591
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License Number State | TN
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Taxonomy #5
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Taxonomy Code | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number | PA16710
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License Number State | TX
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