MEDICARE: DR. CORINA STANCEY 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	207W00000X	Ophthalmology Physician	M1369	TX

General Provider Information

NPI Number	:	1366445165
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CORINA STANCEY MD

Provider Business Mailing Address
First Line	:	1007 RR 620 S
Second Line	:	SUITE 100
City	:	LAKEWAY
State	:	TX
Zip	:	78734-5634
Country	:	US
Telephone Number	:	512-402-9919
Fax Number	:	512-402-9151

Provider Business Practice Location Address
First Line	:	1007 RR 620 S
Second Line	:	SUITE 100
City	:	LAKEWAY
State	:	TX
Zip	:	78734-5634
Country	:	US
Telephone Number	:	512-402-9919
Fax Number	:	512-402-9151

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

Provider Enumeration Date	:	05/24/2005
Last Update Date	:	03/29/2011

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