Basic Information
| Provider Information | |||||||||
| NPI: | 1538619440 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | STONE OAK WOMENS CENTER | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1139 E SONTERRA BLVD STE 205 | ||||||||
| Address2: | |||||||||
| City: | SAN ANTONIO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 782584349 | ||||||||
| CountryCode: | US | ||||||||
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| Address1: | 1139 E SONTERRA BLVD STE 205 | ||||||||
| Address2: | |||||||||
| City: | SAN ANTONIO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 782584349 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2106142229 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/04/2016 | ||||||||
| LastUpdateDate: | 10/04/2016 | ||||||||
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| AuthorizedOfficialLastName: | HARDIN | ||||||||
| AuthorizedOfficialFirstName: | MICHELLE | ||||||||
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| AuthorizedOfficialTitleorPosition: | MD - OBGYN | ||||||||
| AuthorizedOfficialTelephone: | 2106142229 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | AP132132 | TX | Y | 193400000X SINGLE SPECIALTY GROUP | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.