Provider Demographics
NPI:1477783405
Name:STOEPPEL, COLLEEN MARGARET (MD)
Entity Type:Individual
Prefix:
First Name:COLLEEN
Middle Name:MARGARET
Last Name:STOEPPEL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:4835 LBJ FWY STE 900
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75244-6001
Mailing Address - Country:US
Mailing Address - Phone:469-420-5544
Mailing Address - Fax:866-284-2475
Practice Address - Street 1:5323 HARRY HINES BLVD
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75390
Practice Address - Country:US
Practice Address - Phone:214-648-8876
Practice Address - Fax:214-648-2213
Is Sole Proprietor?:No
Enumeration Date:2009-07-24
Last Update Date:2018-08-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXN93082086S0102X, 207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No2086S0102XAllopathic & Osteopathic PhysiciansSurgerySurgical Critical Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXTXB142756Medicare PIN