Provider Demographics
NPI:1497893531
Name:STAT MED P.A.
Entity Type:Organization
Organization Name:STAT MED P.A.
Other - Org Name:STAT MED EMERGENT CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:AKERS
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:512-930-7828
Mailing Address - Street 1:902 N AUSTIN AVE
Mailing Address - Street 2:SUITE 102
Mailing Address - City:GEORGETOWN
Mailing Address - State:TX
Mailing Address - Zip Code:78626-4333
Mailing Address - Country:US
Mailing Address - Phone:512-930-7828
Mailing Address - Fax:512-869-6539
Practice Address - Street 1:902 N AUSTIN AVE
Practice Address - Street 2:SUITE 102
Practice Address - City:GEORGETOWN
Practice Address - State:TX
Practice Address - Zip Code:78626-4333
Practice Address - Country:US
Practice Address - Phone:512-930-7828
Practice Address - Fax:512-869-6539
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-01
Last Update Date:2008-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL2082261QU0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care