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Stephen A Agatston

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NPI Number Detailed Information

Provider Information:

Name: Stephen A Agatston
Gender: M
Provider License Number If Given: H0129

NPI Information:

NPI: 1518966043
Entity Type
(Individual or Organization):
1-ind
Enumeration Date: 7/18/2005

Last Update Date: 1/12/2015

Provider Business Mailing Address:

Address: 12554 RIATA VISTA CIR SUITE 250
Austin, TX 78727
Phone Number: 5127955100
Fax Number: 5127955122

Provider Business Practice Location Address:

Address: 12554 RIATA VISTA CIR SUITE 250
Austin, TX 78727
Phone Number: 5127955100
Fax Number: 5127955122

Provider Taxonomy:

Primary: 2085R0202X
Secondary (if any):
State: TX

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