Provider Demographics
NPI:1255451779
Name:CULOTTA, STANLEY LEO (MD)
Entity type:Individual
Prefix:DR
First Name:STANLEY
Middle Name:LEO
Last Name:CULOTTA
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Gender:M
Credentials:MD
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Mailing Address - Street 1:6243 IH 10 W
Mailing Address - Street 2:STE 480
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78201-2086
Mailing Address - Country:US
Mailing Address - Phone:210-731-4800
Mailing Address - Fax:210-731-4810
Practice Address - Street 1:590 N GENERAL MCMULLEN DR
Practice Address - Street 2:STE 1
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78228-6205
Practice Address - Country:US
Practice Address - Phone:210-249-0212
Practice Address - Fax:210-249-0217
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-29
Last Update Date:2010-03-25
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Provider Licenses
StateLicense IDTaxonomies
TXF-5507207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine