Individual
MICHAEL C STAUDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1515 HOLCOMBE BLVD, HOUSTON, TX 77030-4000
(713) 792-6161
Mailing address
PO BOX 4439, HOUSTON, TX 77210-4439
(713) 792-2991
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
103812
MN
2085R0001X
Radiation Oncology Physician
51288
MN
2085R0001X
Radiation Oncology Physician
56311-20
WI
2085R0001X
Radiation Oncology Physician
Primary
P3455
TX
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
303201301 (MDACC)
—
TX
01
—
8DH744
BCBS (MDACC)
TX
05
—
ENROLLED
—
MN
01
—
P00979634
RAILROAD MEDICARE
MN
Enumeration date
06/16/2008
Last updated
03/29/2022
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