| 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 |