Organization
RICHARD STOVALL MD PA
Active
Other names
Neurosurgical Associates of Austin
Organization subpart
No
Provider details
NPI number
Authorized official
MANDY LYNN ONTIVEROS (OFFICE MANAGER)
(512) 835-8100
Entity
Organization
Contact information
Practice address
2200 PARK BEND DR, BLDG 2, STE 201, AUSTIN, TX 78758-5388
(512) 835-8100
(512) 835-8101
Mailing address
PO BOX 25887, OKLAHOMA CITY, OK 73125-0887
(512) 835-8100
(512) 835-8101
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
K5409
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0098MS
BCBS
TX
05
—
175502701
—
TX
Enumeration date
11/01/2006
Last updated
10/19/2011
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