MEDICARE: ALEXANDER N STADNYK 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	207RP1001X	Pulmonary Disease Physician	H3756	TX

General Provider Information

NPI Number	:	1477823722
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALEXANDER N STADNYK MD

Provider Business Mailing Address
First Line	:	6624 FANNIN ST STE 1450
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77030-2385
Country	:	US
Telephone Number	:	713-799-9916
Fax Number	:	713-799-9917

Provider Business Practice Location Address
First Line	:	6624 FANNIN ST STE 1450
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77030-2385
Country	:	US
Telephone Number	:	713-799-9916
Fax Number	:	713-799-9917

Authorized Official
Title or Position	:	SOLE PROPRIETOR
Name	:	DR. ALEXANDER N STADNYK
Credential	:	M.D.
Telephone Number	:	713-799-9916

Provider Enumeration Date	:	01/04/2012
Last Update Date	:	01/04/2012

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