Individual
PEGGY N. STOLL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
12412 JUDSON RD, LIVE OAK, TX 78233-3255
(210) 581-8399
Mailing address
7418 JOHN SMITH, SUITE 218, SAN ANTONIO, TX 78229-6020
(210) 614-0959
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
G3824
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8M6051
BCBS
TX
01
—
P00082505
MEDICARE RAILROAD
TX
Enumeration date
06/06/2006
Last updated
09/13/2007
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