Individual
DUSTIN STONEWALL DEMOSS
Active
Individual
DUSTIN STONEWALL DEMOSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
P9834
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
337105601
—
TX
01
—
8EJ392
BCBS
TX
01
—
P01447516
RAILROAD MEDICARE
TX
Enumeration date
04/07/2009
Last updated
06/11/2015
Update your record
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