Individual
MICHAEL TODD STAFFORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3560 DELAWARE ST, SUITE 601-A, BEAUMONT, TX 77706-3067
(800) 258-2016
(409) 924-9696
Mailing address
1515 COUNTRY SQUIRE DRIVE, RICHMOND, TX 77406-6642
(281) 341-7676
(409) 924-9696
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
F7193
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0815925
CIGNA
TX
05
—
1380487-06
—
TX
01
—
5994380
AETNA
TX
01
—
81680B
BLUE CROSS BLUE SHIELD
TX
Enumeration date
01/11/2007
Last updated
04/28/2016
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