Provider Demographics
NPI:1467837039
Name:STEPHEN DINGER DO, PLLC
Entity Type:Organization
Organization Name:STEPHEN DINGER DO, PLLC
Other - Org Name:ADVANCED PAIN MANAGEMENT AND REHAB
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DO/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:W
Authorized Official - Last Name:DINGER
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:210-495-7246
Mailing Address - Street 1:5000 SCHERTZ PKWY STE 400
Mailing Address - Street 2:
Mailing Address - City:SCHERTZ
Mailing Address - State:TX
Mailing Address - Zip Code:78154-1457
Mailing Address - Country:US
Mailing Address - Phone:210-495-7246
Mailing Address - Fax:210-495-7245
Practice Address - Street 1:112 HERFF RD STE 320
Practice Address - Street 2:
Practice Address - City:BOERNE
Practice Address - State:TX
Practice Address - Zip Code:78006-2750
Practice Address - Country:US
Practice Address - Phone:210-495-7246
Practice Address - Fax:210-495-7245
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-24
Last Update Date:2024-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
208100000X
TX300913336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1275888679OtherSUBPART NPI
TX315466801OtherSUBPART MEDICAID
TX266007OtherSUBPART MEDICARE PIN
TX1740227107Medicaid