Individual
DALE AUGUST STAGGEMEIER JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
205 E LAVIELLE ST, KIRBYVILLE, TX 75956
(409) 489-8938
(251) 260-8205
Mailing address
PO BOX 2048, JASPER, TX 75951
(409) 489-8938
(251) 260-8205
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
M0627
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11609982
CAQH NUMBER
—
05
—
175132303
—
TX
Enumeration date
08/19/2006
Last updated
05/16/2023
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