Individual
RICHARD B STOVALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2200 PARK BEND DR, BLDG 2 STE 201, AUSTIN, TX 78758-5387
(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
05
—
161400002
—
TX
01
—
8S5890
BC/BS INDIVIDUAL
TX
Enumeration date
09/21/2005
Last updated
01/28/2022
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