Doctor Name: | MS. SANDY L STETZ |
NPI Number: | 1831199140 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | P.A.-C., M.ED. |
License Number: | PA05438 |
Business Practice Address: | 301 Trophy Lake Dr Unit 136 Trophy Club, TX - 762625237 |
Business Phone Number: | 8174309111 |
Business Fax Number: | 8174308911 |
Mailing Address: | 2628 Long Prairie Rd, Suite 107 FLOWER MOUND |
State: | TX |
Postal Code: | 750224839 |
Phone Number: | 9725393695 |
Fax Number: | 9725395419 |
NPI Enumeration Date: | 07/28/2005 |
NPI Last Update Date: | 07/15/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AM0700X |
License Number: | PA05438 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | TX |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Medical |
Taxonomy Definition: |