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Individual

ALAN R STOCKARD

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
855 MONTGOMERY ST, FORT WORTH, TX 76107-2553
(817) 735-2235
(817) 735-2480
Mailing address
PO BOX 99335, FORT WORTH, TX 76199-0335
(817) 735-2235
(817) 735-2480

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
E6970
TX
207QS0010X
Sports Medicine (Family Medicine) Physician
E6970
TX
208D00000X
General Practice Physician
E6970
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
132469109
TX
05
132469110
TX
01
847561
BCBS
TX
01
8BM390
BCBS
TX
01
P00633587
MEDICARE RR
TX
01
P00768237
RAILROAD MEDICARE
TX
Enumeration date
07/03/2006
Last updated
05/09/2011
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