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:
Health care specialties
| Specialty | Code | License # | 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| 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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