Awtrey, Staton

Awtrey, Staton is an individual health care provider with primary practice located at 400 Rosalind Redfern Grover Pkwy Ste 200 , Midland TX 79701-5852. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Cardiovascular Disease, Allopathic & Osteopathic Physicians / Thoracic Surgery (Cardiothoracic Vascular Surgery). Allopathic & Osteopathic Physicians / Thoracic Surgery (Cardiothoracic Vascular Surgery) is his primary health care specialty. Awtrey, Staton can be contacted via phone (432) 221-2107.

Contact Information

Primary practice address
400 Rosalind Redfern Grover Pkwy Ste 200 Midland TX 79701-5852
Phone: (432) 221-2107
Fax: (432) 221-5218
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Cardiovascular Disease 207RC0000X H6019 Texas
Allopathic & Osteopathic Physicians / Thoracic Surgery (Cardiothoracic Vascular Surgery) 208G00000X H6019 Texas

Profile Details

NPI number 1376556019
LBN Legal business name Awtrey, Staton
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 14th, 2006
Last updated Sep 3rd, 2020 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1376556019 NPPES
Texas Other 147713503 MEDICAID - MIDLAND - PFC
Texas Other 8663J0 MEDICAID - MIDLAND - PFC
Texas Other 8663JO MEDICAID - MIDLAND - PFC
Texas Other TXB138584 MEDICAID - MIDLAND - PFC
Texas Other 85010X MEDICAID - MIDLAND - PFC
Texas Other TXB138584 MEDICAID - MIDLAND - PFC
Texas MEDICAID 147713501 MEDICAID - MIDLAND - PFC

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