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Individual

SCOTT STOUGHTON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
CSFA/LSA

Contact information

Practice address
1822 W BRAKER LN # 81603, AUSTIN, TX 78758-3606
(512) 973-9222
(512) 777-4527
Mailing address
PO BOX 81603, AUSTIN, TX 78708-1603
(512) 973-9222
(512) 777-4527

Taxonomy

Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
SA00542
LSA
TX
Enumeration date
09/09/2013
Last updated
06/28/2016
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