Individual
AUTUMN E STOOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
PO BOX 1162, PROSPER, TX 75078-1162
(972) 922-0427
Mailing address
PO BOX 1162, PROSPER, TX 75078
(972) 922-0427
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
N2823
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
208955902
—
TX
01
—
TXB162355
MEDICARE TRAILBLAZER
TX
Enumeration date
05/30/2007
Last updated
02/24/2017
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