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Individual

DR. JEFFREY RONALD STOLTENBERG

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
600 NORTH PARK ST, BRENHAM, TX 77833-2610
(979) 836-6153
Mailing address
PO BOX 844658, DALLAS, TX 75284-4658

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
G5655
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
10011289
SUPERIOR CHIPS
TX
05
101240303
TX
01
AMERIGROUP
AMERIGROUP
TX
Enumeration date
05/23/2005
Last updated
03/04/2026
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