Individual
DAVID L STODDARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
575 HILL COUNTRY DR STE 101, KERRVILLE, TX 78028-6024
(830) 258-7828
Mailing address
PO BOX 650426, DALLAS, TX 75265-0426
(972) 715-5000
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
658772
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
072545
RE-CERT #
—
05
—
172979001
—
TX
05
—
200050370A
—
OK
01
—
8960UC
BCBS PINNACLE ANESTHESIA CONSULTANTS, PA
TX
01
—
8D1570
BCBS PROV #
TX
Enumeration date
03/02/2006
Last updated
02/14/2023
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