Provider Demographics
NPI:1376962530
Name:STAL, DREW NATHANIEL (MD)
Entity Type:Individual
Prefix:
First Name:DREW
Middle Name:NATHANIEL
Last Name:STAL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:902 W RANDOL MILL RD STE 120
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76012-2579
Mailing Address - Country:US
Mailing Address - Phone:817-801-1503
Mailing Address - Fax:817-801-1508
Practice Address - Street 1:902 W RANDOL MILL RD STE 120
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76012-2579
Practice Address - Country:US
Practice Address - Phone:817-801-1503
Practice Address - Fax:817-801-1508
Is Sole Proprietor?:No
Enumeration Date:2014-04-15
Last Update Date:2020-08-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXS5783207X00000X, 207XX0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0004XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryFoot and Ankle Surgery
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery