MEDICARE: DARRELL STANGE FNP

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	363LF0000X	Family Nurse Practitioner	252883	TX

General Provider Information

NPI Number	:	1780650846
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DARRELL STANGE FNP

Provider Business Mailing Address
First Line	:	333 COMMERCE ST
Second Line	:	STE. 700
City	:	NASHVILLE
State	:	TN
Zip	:	37201-1826
Country	:	US
Telephone Number	:	615-913-5086
Fax Number	:	888-494-2588

Provider Business Practice Location Address
First Line	:	2425 WEST LOOP S STE 200
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77027-4208
Country	:	US
Telephone Number	:	956-278-3361
Fax Number	:	855-597-6536

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

Provider Enumeration Date	:	02/27/2006
Last Update Date	:	09/14/2018

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