Provider Demographics
NPI:1447243183
Name:STOJANOVIC, TAMARA (MD)
Entity Type:Individual
Prefix:DR
First Name:TAMARA
Middle Name:
Last Name:STOJANOVIC
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1904 PINE ST
Mailing Address - Street 2:STE. 3A
Mailing Address - City:ABILENE
Mailing Address - State:TX
Mailing Address - Zip Code:79601-2449
Mailing Address - Country:US
Mailing Address - Phone:325-670-4033
Mailing Address - Fax:325-670-4051
Practice Address - Street 1:1904 PINE ST
Practice Address - Street 2:STE. 3A
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79601-2344
Practice Address - Country:US
Practice Address - Phone:325-670-4033
Practice Address - Fax:325-670-4051
Is Sole Proprietor?:No
Enumeration Date:2005-08-29
Last Update Date:2021-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK7622207R00000X, 207RC0200X, 207RS0012X, 207RP1001X
INCV2005367207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0079MQOtherBLUE CROSS
TX124859101OtherFIRST CARE
TX124859101OtherFIRST CARE
TX0079MQOtherBLUE CROSS