Individual
STEFANIE MEYER REISCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
6801 OAKMONT BLVD STE 102, FORT WORTH, TX 76132-3903
(866) 376-8768
Mailing address
5001 S COOPER ST STE 201, ARLINGTON, TX 76017-5993
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
PA12527
TX
363A00000X
Physician Assistant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1114114279
—
TX
Enumeration date
11/27/2018
Last updated
01/29/2025
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