Provider Demographics
NPI:1053768275
Name:STOLL, KRISTIN E (DO)
Entity type:Individual
Prefix:
First Name:KRISTIN
Middle Name:E
Last Name:STOLL
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3551 ROGER BROOKE DR
Mailing Address - Street 2:
Mailing Address - City:JBSA FT SAM HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:78234-4504
Mailing Address - Country:US
Mailing Address - Phone:210-916-8056
Mailing Address - Fax:210-916-4721
Practice Address - Street 1:3551 ROGER BROOKE DR
Practice Address - Street 2:
Practice Address - City:JBSA FT SAM HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:78234-4504
Practice Address - Country:US
Practice Address - Phone:210-916-4808
Practice Address - Fax:210-916-3366
Is Sole Proprietor?:No
Enumeration Date:2016-05-17
Last Update Date:2024-05-30
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Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0102205802207RH0003X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0102205802OtherCOMMONWEALTH OF VIRGINIA BOARD OF MEDICINE