Organization
SCOTT T STOLL DO PHD PA
Active
Other names
Stoll Neurodiagnostics
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SCOTT T STOLL D.O. (PRESIDENT)
(817) 294-3195
Entity
Organization
Contact information
Practice address
5717 EDWARDS RANCH RD, FORT WORTH, TX 76109-4116
(817) 294-3195
(817) 294-3466
Mailing address
5717 EDWARDS RANCH RD, FORT WORTH, TX 76109-4116
(817) 294-3195
(817) 294-3466
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
H9575
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0027TA
BCBS
TX
05
—
211320101
—
TX
Enumeration date
09/30/2009
Last updated
05/29/2014
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