Rachenetta V Stimage MD PA

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

M9680 Issued in TX

Legal business name

RACHENETTA V STIMAGE MD PA

Practice address

4360 N Josey LN
Carrollton, TX 75010-4602

Phone

(972) 492-7606

Fax

(972) 492-0105

NPI assigned

Dec 5, 2012

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Crystal Marie Graham

Title

Office Manager

Phone

(972) 492-7606

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1354665600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1558310400000",
    "number": "1154666980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4360 N JOSEY LN",
            "city": "CARROLLTON",
            "state": "TX",
            "postal_code": "750104602",
            "telephone_number": "972-492-7606",
            "fax_number": "972-492-0105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4360 N JOSEY LN",
            "city": "CARROLLTON",
            "state": "TX",
            "postal_code": "750104602",
            "telephone_number": "972-492-7606",
            "fax_number": "972-492-0105"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4325 N Josey Ln",
            "address_2": "Suite 210",
            "address_purpose": "LOCATION",
            "city": "Carrollton",
            "state": "TX",
            "postal_code": "750104635",
            "country_code": "US",
            "telephone_number": "463-316-3216",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "RACHENETTA V STIMAGE MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-12-05",
        "last_updated": "2019-05-20",
        "status": "A",
        "authorized_official_last_name": "GRAHAM",
        "authorized_official_first_name": "CRYSTAL",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "972-492-7606"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": "TX",
            "license": "M9680",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Obstetrics & Gynecology Physician in Carrollton, TX
• Providers in Carrollton, TX by specialty
• Obstetrics & Gynecology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.