Provider Demographics
NPI:1639854508
Name:STALLKNECHT, EMALIE (CAA)
Entity Type:Individual
Prefix:
First Name:EMALIE
Middle Name:
Last Name:STALLKNECHT
Suffix:
Gender:F
Credentials:CAA
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Other - Credentials:
Mailing Address - Street 1:162 APRIL POINT DR N
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:TX
Mailing Address - Zip Code:77356-5832
Mailing Address - Country:US
Mailing Address - Phone:936-232-4699
Mailing Address - Fax:
Practice Address - Street 1:9250 PINECROFT DR
Practice Address - Street 2:
Practice Address - City:SHENANDOAH
Practice Address - State:TX
Practice Address - Zip Code:77380-3218
Practice Address - Country:US
Practice Address - Phone:713-897-2300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-19
Last Update Date:2023-06-19
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367H00000XPhysician Assistants & Advanced Practice Nursing ProvidersAnesthesiologist Assistant