Basic Information
| Provider Information | |||||||||
| NPI: | 1649259235 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | PRITCHARD | ||||||||
| FirstName: | STEPHEN | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 638 E MARKET ST | ||||||||
| Address2: | |||||||||
| City: | ROCKPORT | ||||||||
| State: | TX | ||||||||
| PostalCode: | 783822530 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3617290646 | ||||||||
| FaxNumber: | 3617298854 | ||||||||
| Practice Location | |||||||||
| Address1: | 638 E MARKET ST | ||||||||
| Address2: | |||||||||
| City: | ROCKPORT | ||||||||
| State: | TX | ||||||||
| PostalCode: | 783822530 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3617290646 | ||||||||
| FaxNumber: | 3617298854 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/11/2006 | ||||||||
| LastUpdateDate: | 01/08/2008 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | D9614 | TX | N | Allopathic & Osteopathic Physicians | Emergency Medicine | 207Q00000X | D9614 | TX | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.