Provider Demographics
NPI:1861763583
Name:STELMACH INC
Entity type:Organization
Organization Name:STELMACH INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:W
Authorized Official - Last Name:STELMACH
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:713-581-4919
Mailing Address - Street 1:PO BOX 842198
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77284-2198
Mailing Address - Country:US
Mailing Address - Phone:713-581-4919
Mailing Address - Fax:281-855-2998
Practice Address - Street 1:7058 LAKEVIEW HAVEN DR
Practice Address - Street 2:SUITE 124
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77095-2682
Practice Address - Country:US
Practice Address - Phone:713-581-4919
Practice Address - Fax:281-855-2998
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-26
Last Update Date:2012-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX207Q00000X, 364SF0001X
TX9534111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No364SF0001XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistFamily HealthGroup - Multi-Specialty