Individual
STEPHEN EDWARD EARLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
12315 JUDSON RD, # 208, LIVE OAK, TX 78233-3277
(210) 872-6572
(210) 651-5137
Mailing address
PO BOX 33577, SAN ANTONIO, TX 78265-3577
(210) 872-6572
(210) 651-5137
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
F3917
TX
207XS0117X
Orthopaedic Surgery of the Spine Physician
F3917
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
033081302
—
TX
05
—
169383001
—
TX
01
—
201626736
TAX ID #
TX
01
—
602044900
U.S. DOL #
TX
Enumeration date
06/30/2005
Last updated
10/06/2009
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