Individual
MS. DANELL REITER STUCKEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
6218 NW LOOP 410, SAN ANTONIO, TX 78238-3306
(210) 523-1411
(210) 523-9307
Mailing address
8637 FREDERICKSBURG RD, SUITE 360, SAN ANTONIO, TX 78240-1219
(210) 617-4029
(210) 617-4075
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
M6901
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
002
TRICARE LOCATION
TX
01
—
048
TRICARE LOCATION
TX
05
—
1960695001
—
TX
01
—
9485370
PHCS
TX
Enumeration date
07/03/2007
Last updated
12/05/2011
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