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Individual
STEPHEN A DITTA
Active
Individual
STEPHEN A DITTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
3624T
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
093346701
—
TX
01
—
2813517378
VISION SERVICE PLAN
TX
01
—
760194385
COMP BENEFITS
TX
01
—
930127
BLOCK VISION
TX
Enumeration date
10/28/2005
Last updated
06/11/2014
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