Daniel L Stickler II, M.D.

Individual provider Active NPI General Practice Physician · Driftwood, TX

NPI 1346295698 · NPPES record last updated Jul 22, 2024

Key facts

NPI
1346295698
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Physician 208D00000X
License
S4397 (TX)
Practice address
3353 Tuscany Dr
Driftwood, TX 78619-2056
Phone
(512) 560-3694
Fax
(828) 330-4985
NPI assigned
May 24, 2006
Sex
Male
Sole proprietor
Yes

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME144084FLMDGeneral Practice Physician
2011-01840NCMDGeneral Practice Physician
S4397TXMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Az Medical PLLC General Practice Current
since Jun 16, 2024
Accepting new patients
Michael M Boustany MD Inc Past Accepting new patients

Locations

919 Congress Ave
Ste 525
Austin, TX 78701
Phone (512) 522-0966

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X ME144084 FL
General Practice Physician 208D00000X 2011-01840 NC
General Practice Physician 208D00000X S4397 TX Yes

Addresses

Primary practice location

3353 Tuscany Dr
Driftwood, TX 78619-2056

Mailing address

3353 Tuscany Dr
Driftwood, TX 78619-2056
Phone (512) 560-3694

Other practice location 1

919 Congress Ave Ste 525
Austin, TX 78701-2163
Phone (512) 522-0966

Other providers in Driftwood, TX

All providers in Driftwood, TX · General Practice Physician in Texas

Sources for this page

Verify at the official NPI Registry.