Provider Demographics
NPI:1073509220
Name:HOEFLE, STEPHANIE ANNE (MD)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:ANNE
Last Name:HOEFLE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:STEPHANIE
Other - Middle Name:ANNE
Other - Last Name:FAVALORO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:700 E SONTERRA BLVD STE 202
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78258-4386
Mailing Address - Country:US
Mailing Address - Phone:210-496-7999
Mailing Address - Fax:210-494-1666
Practice Address - Street 1:700 E SONTERRA BLVD STE 202
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78258-4386
Practice Address - Country:US
Practice Address - Phone:210-496-7999
Practice Address - Fax:210-494-1666
Is Sole Proprietor?:No
Enumeration Date:2005-09-23
Last Update Date:2020-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA37247207Q00000X
AL24750207Q00000X
GA051333207Q00000X
TXK2715207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
H07839Medicare UPIN