Provider Demographics
NPI:1053584334
Name:DAVID P. STAPENHORST, M.D., P.A.
Entity type:Organization
Organization Name:DAVID P. STAPENHORST, M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:PERRIN
Authorized Official - Last Name:STAPENHORST
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:281-980-0999
Mailing Address - Street 1:4665 SWEETWATER BLVD
Mailing Address - Street 2:SUITE 110
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77479-3135
Mailing Address - Country:US
Mailing Address - Phone:281-980-0999
Mailing Address - Fax:
Practice Address - Street 1:4665 SWEETWATER BLVD
Practice Address - Street 2:SUITE 110
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77479-3135
Practice Address - Country:US
Practice Address - Phone:281-980-0999
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-08
Last Update Date:2008-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM5522208200000X, 208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Multi-Specialty
No208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty