MEDICARE: DR. STUART R LANDER MD

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
1	207RC0000X	Cardiovascular Disease Physician	K2733	TX
2	207UN0901X	Nuclear Cardiology Physician	K2733	TX
3	207RI0011X	Interventional Cardiology Physician	K2733	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	8DG185	OTHER	TX	BCBS
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1215991906
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. STUART R LANDER MD

Provider Business Mailing Address
First Line	:	16980 DALLAS PKWY STE 200
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75248-1974
Country	:	US
Telephone Number	:	972-391-1915
Fax Number	:	972-391-2061

Provider Business Practice Location Address
First Line	:	902 W RANDOL MILL RD STE 200
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76012-2581
Country	:	US
Telephone Number	:	817-461-3003
Fax Number	:	844-290-4365

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/12/2006
Last Update Date	:	09/22/2022

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Directions to “ DR. STUART R LANDER MD” Practice Location

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