Individual
ANTHONY THOMAS STAVROS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5253 PRUE RD, SUITE 315, BUILDING 3, SAN ANTONIO, TX 78240-1758
(707) 849-6548
Mailing address
5253 PRUE RD, SUITE 315, BUILDING 3, SAN ANTONIO, TX 78240-1758
(707) 849-6548
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
18255
CO
2085R0202X
Diagnostic Radiology Physician
Primary
Q2069
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01182559
—
CO
05
—
053211101
—
TX
05
—
104686383
—
MI
05
—
117210700
—
WY
05
—
1982658381
—
UT
05
—
200425010A
—
KS
01
—
300048672
RR MIC MCRE
CO
01
—
300090433
RR DIA MCRE
CO
01
—
300090435
RR RIA MCRE
CO
Enumeration date
05/20/2006
Last updated
04/29/2015
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