Provider Demographics
NPI:1801952213
Name:STEIXNER, BRIAN L (MD)
Entity type:Individual
Prefix:
First Name:BRIAN
Middle Name:L
Last Name:STEIXNER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2169 SOUTH AVE
Mailing Address - Street 2:
Mailing Address - City:SOUTH LAKE TAHOE
Mailing Address - State:CA
Mailing Address - Zip Code:96150-7059
Mailing Address - Country:US
Mailing Address - Phone:530-543-5400
Mailing Address - Fax:530-544-1959
Practice Address - Street 1:2169 SOUTH AVE
Practice Address - Street 2:
Practice Address - City:SOUTH LAKE TAHOE
Practice Address - State:CA
Practice Address - Zip Code:96150-7059
Practice Address - Country:US
Practice Address - Phone:530-543-5400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-29
Last Update Date:2021-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV18722208800000X
PAMT185953208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ106682OtherMEDICARE GROUP