Individual
DAVID STATEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APRN; A/G ACNP
Contact information
Practice address
700 SCOTT AND WHITE DR, COLLEGE STATION, TX 77845-6441
(979) 207-0100
(979) 207-2161
Mailing address
6516 NEW RD, NORTH ZULCH, TX 77872-6337
(281) 740-2405
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
663393
TX
363LA2100X
Acute Care Nurse Practitioner
Primary
AP125278
TX
363LC0200X
Critical Care Medicine Nurse Practitioner
AP125278
TX
363LF0000X
Family Nurse Practitioner
AP125278
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8889NJ
BLUE CROSS BLUE SHIELD
TX
01
—
P01402891
RR MEDICARE
TX
Enumeration date
03/18/2014
Last updated
03/29/2024
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