Provider Demographics
NPI:1063606853
Name:STONE OAK SPINE P.A.
Entity type:Organization
Organization Name:STONE OAK SPINE P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:JEFFERY
Authorized Official - Middle Name:S
Authorized Official - Last Name:TURNER
Authorized Official - Suffix:
Authorized Official - Credentials:PT, MDT
Authorized Official - Phone:210-402-2920
Mailing Address - Street 1:400 N LOOP 1604E
Mailing Address - Street 2:SUITE 345
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78232-1223
Mailing Address - Country:US
Mailing Address - Phone:210-402-2920
Mailing Address - Fax:210-403-9827
Practice Address - Street 1:400 N LOOP 1604E
Practice Address - Street 2:SUITE 345
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78232-1223
Practice Address - Country:US
Practice Address - Phone:210-402-2920
Practice Address - Fax:210-403-9827
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-05
Last Update Date:2007-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX658707OtherBCBS OF TEXAS
TX650494Medicare PIN