Individual
DR. STEPHEN L. PUTTHOFF
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
3500 CAMP BOWIE BLVD, EAD 318, FORT WORTH, TX 76107-2644
(817) 735-2429
Mailing address
3500 CAMP BOWIE BLVD, UNTHSC DEPT. OF QUALITY MANAGEMENT. EAD 324, FORT WORTH, TX 76107
(817) 735-0111
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
H2164
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CLO426
BLUE CROSS AND BLUE SHIEL
—
Enumeration date
03/14/2006
Last updated
07/09/2007
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