| Michael W Stavinoha Md Pa | |
|
1631 North Loop West Suite 655 Houston TX 77008 | |
| (713) 869-8200 | |
| (713) 867-2013 |
| Full Name | Michael W Stavinoha Md Pa |
|---|---|
| Speciality | Internal Medicine |
| Location | 1631 North Loop West, Houston, Texas |
| Authorized Official Name and Position | Michael W Stavinoha (PHYSICIAN) |
| Authorized Official Contact | 7138698200 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Michael W Stavinoha Md Pa 1631 North Loop West Suite 655 Houston TX 77008 Ph: (713) 869-8200 | Michael W Stavinoha Md Pa 1631 North Loop West Suite 655 Houston TX 77008 Ph: (713) 869-8200 |
| NPI Number | 1578755203 |
|---|---|
| Provider Enumeration Date | 08/16/2007 |
| Last Update Date | 01/14/2011 |
| Medicare PECOS PAC ID | 6204025711 |
|---|---|
| Medicare Enrollment ID | O20110114000529 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578755203 | NPI | - | NPPES |
| 127858203 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | G8436 (Texas) | Primary |
| Provider Name | Michael W Stavinoha |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1154345593 PECOS PAC ID: 4486782091 Enrollment ID: I20110114000556 |
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