Provider Demographics
NPI:1356445092
Name:STELZER, MICHAEL MARTIN (DC)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:MARTIN
Last Name:STELZER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:615 NW LOOP 410
Mailing Address - Street 2:SUITE 150
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78216-5519
Mailing Address - Country:US
Mailing Address - Phone:210-384-0777
Mailing Address - Fax:210-384-0772
Practice Address - Street 1:615 NW LOOP 410
Practice Address - Street 2:SUITE 150
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78216-5519
Practice Address - Country:US
Practice Address - Phone:210-384-0777
Practice Address - Fax:210-384-0772
Is Sole Proprietor?:No
Enumeration Date:2006-09-12
Last Update Date:2008-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX8225111N00000X, 111NN0400X, 111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN0400XChiropractic ProvidersChiropractorNeurology
No111N00000XChiropractic ProvidersChiropractor
No111NS0005XChiropractic ProvidersChiropractorSports Physician
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8B2221OtherBCBS PROVIDER NUMBER
TXU43837Medicare UPIN
TX8F1236Medicare ID - Type Unspecified