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NPI Code Detail

MEDICARE: MRS. STEFFANY LEA MOCK PA-C

MEDICARE:  MRS. STEFFANY LEA MOCK  PA-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363AM0700XMedical Physician AssistantPA03206TX

General Provider Information

NPI Number : 1194996314
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. STEFFANY LEA MOCK PA-C
Provider Business Mailing Address
First Line : 19260 STONE OAK PKWY
Second Line : SUITE 105
City : SAN ANTONIO
State : TX
Zip : 78258-3365
Country : US
Telephone Number : 210-402-3456
Fax Number :
Provider Business Practice Location Address
First Line : 19260 STONE OAK PKWY
Second Line : SUITE 105
City : SAN ANTONIO
State : TX
Zip : 78258-3365
Country : US
Telephone Number : 210-402-3456
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/14/2008
Last Update Date : 06/02/2009

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Directions to “ MRS. STEFFANY LEA MOCK PA-C” Practice Location

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