SCOTT STEGALL PA-C NPI 1356323034

NPI Information

NPI: 1356323034
Provider Name: SCOTT STEGALL, PA-C
Classification: Physician Assistant - 363AM0700X
Entity Type: Individual

Specialization: Medical

PECOS Registration: Yes

Address:
5414 S BROADWAY AVE
TYLER, TX
ZIP 75703
Phone: (903) 581-1601
Get Directions

Scott Stegall, PA-C is a medical physician assistant in Tyler, TX. Scott Stegall, PA-C NPI is 1356323034. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

5414 S BROADWAY AVE
TYLER, TX
ZIP 75703-335
Phone: (903) 581-1601
Fax: (903) 581-1638

The NPI 1356323034 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 11/17/2005 and was last updated on 7/17/2017.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363AM0700X	Physician Assistant	Medical	PA01268	TEXAS	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	8780MD	OTHER	TEXAS	BCBS
2	P01811994	OTHER	TEXAS	RAIL ROAD MEDICARE
3	8854MB	OTHER	TEXAS	BCBS
4	348859YK7L	MEDICARE PIN	TEXAS
5	P01811499	OTHER	TEXAS	RAIL ROAD MEDICARE
6	337197302	MEDICAID	TEXAS
7	83N235	MEDICARE PIN	TEXAS
8	S68083	MEDICARE UPIN	TEXAS
9	337197303	MEDICAID	TEXAS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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