MEDICARE: DR. FELICIA STONEDALE M.D.

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	208D00000X	General Practice Physician	F7626	TX
2	207P00000X	Emergency Medicine Physician	F7626	TX

General Provider Information

NPI Number	:	1689696254
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. FELICIA STONEDALE M.D.

Provider Business Mailing Address
First Line	:	PO BOX 341618
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78734-0027
Country	:	US
Telephone Number	:	512-266-2681
Fax Number	:

Provider Business Practice Location Address
First Line	:	5708 LONGHORN LNDG
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78734-1523
Country	:	US
Telephone Number	:	512-266-2681
Fax Number	:

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

Provider Enumeration Date	:	07/24/2006
Last Update Date	:	05/08/2008

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