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Individual
DR. STATON AWTREY
Active
Individual
DR. STATON AWTREY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
H6019
TX
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
H6019
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
147713501
—
TX
01
—
147713503
MEDICAID - MIDLAND - PFC
TX
01
—
85010X
BCBS SAN ANGELO ID NUMBER
TX
01
—
8663J0
BCBS AUSTIN ID NUMBER
TX
01
—
8663JO
MEDICARE PIN SAN ANGELO
TX
01
—
TXB138584
TX MEDICARE-PREMIER
TX
Enumeration date
08/14/2006
Last updated
09/03/2020
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