Individual
DR. KEVIN M STANCOVEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
201 SETON PARKWAY, SETON MEDICAL CENTER WILLIAMSON, ROUND ROCK, TX 78665
(512) 814-0298
(512) 597-2713
Mailing address
P.O. BOX 2386, BRAZOS VALLEY PATHOLOGY, ROUND ROCK, TX 78664
(972) 489-0201
(512) 597-2713
Taxonomy
Speciality
Code
Description
License number
State
207ZC0500X
Cytopathology Physician
N5415
TX
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
N5415
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2866683
—
TX
01
—
TXB132498
MEDICARE
TX
Enumeration date
05/21/2007
Last updated
10/30/2014
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