Individual
ALEXANDER STOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
332 WILDER WAY, TYLER, TX 75703-9370
(903) 534-0838
Mailing address
332 WILDER WAY, TYLER, TX 75703-9370
(903) 534-0838
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
F0020
TX
2083X0100X
Occupational Medicine Physician
F0020
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
117678602
—
TX
01
—
123273
SUPERIOR CHIPS
TX
01
—
83Y757
BCBS OF TEXAS
TX
Enumeration date
02/20/2006
Last updated
01/22/2015
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