Individual
DR. MARK A STILLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
10301 GATEWAY BLVD W, EL PASO, TX 79925-7701
(915) 595-9000
Mailing address
6905 MINERAL RIDGE DR, EL PASO, TX 79912-7694
(191) 584-5007
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
J6041
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1336109818
NPI
TX
05
—
40674827
—
NM
01
—
8U6942
BCBS
TX
01
—
P00323514
RAILROAD
TX
Enumeration date
03/27/2006
Last updated
07/08/2007
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