Provider Demographics
NPI:1518137074
Name:STREFLING ORTHOPAEDIC SURGERY, PA
Entity Type:Organization
Organization Name:STREFLING ORTHOPAEDIC SURGERY, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ROSA
Authorized Official - Middle Name:
Authorized Official - Last Name:BYRD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:325-643-5445
Mailing Address - Street 1:125 SOUTH PARK DRIVE
Mailing Address - Street 2:STE B
Mailing Address - City:BROWNWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:76801-5952
Mailing Address - Country:US
Mailing Address - Phone:325-643-5445
Mailing Address - Fax:325-643-5447
Practice Address - Street 1:125 SOUTH PARK DRIVE
Practice Address - Street 2:STE B
Practice Address - City:BROWNWOOD
Practice Address - State:TX
Practice Address - Zip Code:76801-5952
Practice Address - Country:US
Practice Address - Phone:325-643-5445
Practice Address - Fax:325-643-5447
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-11
Last Update Date:2008-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ5491207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0013RCOtherBCBS GROUP
TX0346454-01Medicaid
TX0013RCOtherBCBS GROUP
TX00L78HMedicare PIN
TXA95627Medicare UPIN