Active NPI
Michael Dale Stolba, D.C.
- Chiropractor
- Texarkana, TX
National Provider Identifier
1942307913
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 9041
- Practice address
- 507 Main St
Texarkana, TX 75501-5503 - Phone
- (903) 794-7981
- Fax
- (903) 792-0288
- NPI assigned
- Sep 20, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 9041 | TX | Primary |
| Chiropractor | 111N00000X | 1623 | AR |
Addresses
Primary practice location
507 Main St
Texarkana, TX 75501-5503
Mailing address
507 Main St
Texarkana, TX 75501-5503
Phone (903) 794-7981
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8F2413 | Other | TX | BC/BS PROVIDER # |
| 5F123 | Other | AR | BC/BS AR GROUP # |
| 0026HJ | Other | TX | BC/BS GROUP # |
| 5X792 | Other | AR | BC/BS AR PROVIDER # |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9041 | TX | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158710400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1942307913",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "507 MAIN ST",
"city": "TEXARKANA",
"state": "TX",
"postal_code": "755015503",
"telephone_number": "903-794-7981",
"fax_number": "903-792-0288"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "507 MAIN ST",
"city": "TEXARKANA",
"state": "TX",
"postal_code": "755015503",
"telephone_number": "903-794-7981",
"fax_number": "903-792-0288"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STOLBA",
"first_name": "MICHAEL",
"middle_name": "DALE",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-09-20",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "TX",
"license": "9041",
"primary": true
},
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "AR",
"license": "1623",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BC/BS PROVIDER #",
"identifier": "8F2413",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BC/BS AR GROUP #",
"identifier": "5F123",
"state": "AR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BC/BS GROUP #",
"identifier": "0026HJ",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BC/BS AR PROVIDER #",
"identifier": "5X792",
"state": "AR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Texarkana, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.