Provider Demographics
NPI:1386620243
Name:DOCKSTADER, STEVEN F (MD)
Entity type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:F
Last Name:DOCKSTADER
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:PO BOX 840853
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75284-0853
Mailing Address - Country:US
Mailing Address - Phone:972-233-1999
Mailing Address - Fax:972-233-3666
Practice Address - Street 1:6606 LBJ FWY
Practice Address - Street 2:SUITE 200
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75240
Practice Address - Country:US
Practice Address - Phone:972-715-5000
Practice Address - Fax:972-715-9976
Is Sole Proprietor?:No
Enumeration Date:2005-12-21
Last Update Date:2018-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH8001207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX117849305Medicaid
TX8EH558OtherBCBS
TX89587KMedicare PIN
TX340180YK6UMedicare PIN
G38416Medicare UPIN
TX83845KOtherBCBS
TX340180YK6UMedicare PIN
TX89587KMedicare PIN
G38416Medicare UPIN
TX89615KMedicare PIN
TXTXB107626Medicare PIN