Provider Demographics
NPI:1659453306
Name:STEIN, SCOTT P (DOPA)
Entity Type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:P
Last Name:STEIN
Suffix:
Gender:M
Credentials:DOPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:601 E SAN ANTONIO ST
Mailing Address - Street 2:STE 305W
Mailing Address - City:VICTORIA
Mailing Address - State:TX
Mailing Address - Zip Code:77901-6052
Mailing Address - Country:US
Mailing Address - Phone:361-572-9772
Mailing Address - Fax:361-572-9747
Practice Address - Street 1:605 E SAN ANTONIO ST STE 330-E
Practice Address - Street 2:
Practice Address - City:VICTORIA
Practice Address - State:TX
Practice Address - Zip Code:77901-6040
Practice Address - Country:US
Practice Address - Phone:361-572-9772
Practice Address - Fax:361-572-9747
Is Sole Proprietor?:No
Enumeration Date:2006-10-20
Last Update Date:2018-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX59362207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX089841301Medicaid
TX00T5414Medicare ID - Type Unspecified
G10056Medicare UPIN