MEDICARE: EILEEN C STADE 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	207R00000X	Internal Medicine Physician	F2035	TX

General Provider Information

NPI Number	:	1861494668
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EILEEN C STADE M.D.

Provider Business Mailing Address
First Line	:	8200 WEDNESBURY LN
Second Line	:	SUITE 485
City	:	HOUSTON
State	:	TX
Zip	:	77074-2925
Country	:	US
Telephone Number	:	713-981-9989
Fax Number	:	713-981-7019

Provider Business Practice Location Address
First Line	:	8200 WEDNESBURY LN
Second Line	:	SUITE 485
City	:	HOUSTON
State	:	TX
Zip	:	77074-2925
Country	:	US
Telephone Number	:	713-981-9989
Fax Number	:	713-981-7019

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

Provider Enumeration Date	:	08/11/2005
Last Update Date	:	07/08/2007

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Directions to “ EILEEN C STADE M.D.” Practice Location

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