Individual
DOUGLAS STAFFORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
1222 N MAIN AVE, SUITE 740, SAN ANTONIO, TX 78212-5712
(210) 271-7411
Mailing address
1222 N MAIN AVE, SUITE 740, SAN ANTONIO, TX 78212-5712
(210) 271-7411
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MT037546
TX
Other
Enumeration date
08/28/2007
Last updated
09/25/2007
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