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Organization

PEDIATRIC OPHTHALMOLOGY PA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DAVID R STAGER SR. MD (PRESIDENT)
(214) 369-6434
Entity
Organization

Contact information

Practice address
6200 W PARKER RD, # 508, PLANO, TX 75093-7939
(972) 981-8389
(972) 981-3242
Mailing address
8222 DOUGLAS AVE, STE 400, DALLAS, TX 75225-5923
(214) 369-6434
(214) 696-6273

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
158493001
TX
01
CJ6189
RAILROAD MEDICARE
TX
Enumeration date
04/09/2007
Last updated
05/06/2008
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