Provider Demographics
NPI:1588660039
Name:STEFANI, ANNE MILIA (MD)
Entity Type:Individual
Prefix:DR
First Name:ANNE
Middle Name:MILIA
Last Name:STEFANI
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 1:3410 FAR WEST BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78731-3187
Mailing Address - Country:US
Mailing Address - Phone:512-717-9775
Mailing Address - Fax:512-599-5034
Practice Address - Street 1:3410 FAR WEST BLVD STE 100
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78731-3187
Practice Address - Country:US
Practice Address - Phone:512-717-9775
Practice Address - Fax:512-599-5034
Is Sole Proprietor?:No
Enumeration Date:2005-06-21
Last Update Date:2018-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK4577207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXE51803Medicare UPIN
TXE51803Medicare UPIN