Provider Demographics
NPI:1184110801
Name:ELECT DERMATOLOGY PLLC
Entity type:Organization
Organization Name:ELECT DERMATOLOGY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:
Authorized Official - Last Name:STAHR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:415-802-1310
Mailing Address - Street 1:2154 GABRIELS PL STE 103
Mailing Address - Street 2:
Mailing Address - City:NEW BRAUNFELS
Mailing Address - State:TX
Mailing Address - Zip Code:78130-5475
Mailing Address - Country:US
Mailing Address - Phone:415-802-1310
Mailing Address - Fax:
Practice Address - Street 1:2154 GABRIELS PL STE 103
Practice Address - Street 2:
Practice Address - City:NEW BRAUNFELS
Practice Address - State:TX
Practice Address - Zip Code:78130-5475
Practice Address - Country:US
Practice Address - Phone:415-802-1310
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-05
Last Update Date:2020-07-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Multi-Specialty