Provider Demographics
NPI:1649507930
Name:DAVID STAGER, JR. M.D., P.A.
Entity type:Organization
Organization Name:DAVID STAGER, JR. M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:
Authorized Official - Last Name:ROLLINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-758-0625
Mailing Address - Street 1:3900 W 15TH ST
Mailing Address - Street 2:STE 406
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75075-7751
Mailing Address - Country:US
Mailing Address - Phone:972-758-0625
Mailing Address - Fax:
Practice Address - Street 1:3900 W 15TH ST
Practice Address - Street 2:STE 406
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75075-7751
Practice Address - Country:US
Practice Address - Phone:972-758-0625
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-08
Last Update Date:2009-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ1572207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty