NPI | 1013231216 |
---|---|
Doing Business As | STONE OAK DERMATOLOGY |
Entity Type | Organization |
Authorized Contact | LINDA JANE BANTA Owner/Physician 210-494-0504 |
Organization Subpart ? | No |
Primary Taxonomy | 207N00000X Dermatology (Licence: TX J3779) |
Enumeration Date | 2010-03-17 |
Last Update Date | 2010-08-09 |