Brooke Marie Stidham (NPI# 1134450497, PAC ID# 4284762055) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is PHYSICIAN ASSISTANT.
| Nation Provider ID (NPI) | 1134450497 |
| PAC ID by PECOS | 4284762055 |
| Professional Enrollment ID | I20140205000570 |
| Full Name | Brooke Marie Stidham |
| Organization Legal Name | LADERA PARK DERMATOLOGY PA |
| Address |
11671 Jollyville Rd Suite 104 Austin TX 78759-4141 |
| Phone Number | 5123453599 |
| Gender | F |
| Graduation Year | 2007 |
| Primary Specialty | PHYSICIAN ASSISTANT |
| Group Practice PAC ID | 5597030189 |
| Number of Group Practice Members | 2 |
| Accepts Medicare Assignment | Y |
| Address | Phone | Organization |
|---|---|---|
| 11671 Jollyville Rd, Suite 104, Austin, TX 78759-4141 | 5123453599 | LADERA PARK DERMATOLOGY PA |
| Organization Legal Name | LADERA PARK DERMATOLOGY PA |
| Physicians | 3 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Adrienne M Feasel | Dermatology | Ladera Park Dermatology Pa | 1201 W 38th St, Austin, TX 78705-1006 |
| Janet C Dubois | Dermatology | Ladera Park Dermatology Pa | 11671 Jollyville Rd, Suite 104, Austin, TX 78759-4141 |
| Street Address |
11671 JOLLYVILLE RD SUITE 104 |
| City | AUSTIN |
| State | TX |
| Zip | 78759-4141 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Deirdre M Rhoad | Plastic and Reconstructive Surgery | 11671 Jollyville Rd, Suite 103, Austin, TX 78759-4141 | |
| John F Bangston Jr. | Emergency Medicine | 11671 Jollyville Rd, Suite 203, Austin, TX 78759-4141 | |
| Paul W John | Family Medicine | 11671 Jollyville Rd, Suite 202, Austin, TX 78759-4141 | |
| Todd E Crump | Family Medicine | Seton Family of Doctors | 11671 Jollyville Rd, Suite 102, Austin, TX 78759-4141 |
| Janet C Dubois | Dermatology | Ladera Park Dermatology Pa | 11671 Jollyville Rd, Suite 104, Austin, TX 78759-4141 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Michele K Gerard | Chiropractic | 4131 Spicewood Springs, Suite L 3, Austin, TX 78759 | |
| Joanna K Meley | Nurse Practitioner | Rediclinic Austin LLC | 11521 Ranch Rd 620, Rediclinic, Austin, TX 78759-1139 |
| John W Kok | Chiropractic | 12593 Research Blvd, Suite 205, Austin, TX 78759-2214 | |
| William D Holmes | Psychiatry | 12515 Research Blvd, Suite 400, Austin, TX 78759-2228 | |
| John D Odette | Ophthalmology | Austin Eye Clinic Association | 11901 Jollyville Rd, Austin, TX 78759-2303 |
| Marie Thanh-thao Bui | Ophthalmology | Austin Eye Clinic Association | 11901 Jollyville Rd, Austin, TX 78759-2303 |
| Whitney Gail Cansler | Optometry | Austin Eye Clinic Association | 11901 Jollyville Rd, Austin, TX 78759-2303 |
| Shannon M Wong | Ophthalmology | Austin Eye Clinic Association | 11901 Jollyville Rd, Austin, TX 78759-2303 |
| Mitchel Wong | Ophthalmology | Austin Eye Clinic Association | 11901 Jollyville Rd, Austin, TX 78759-2303 |
| Gilan Levy | Clinical Social Worker | Shalom Austin | 11940 Jollyville Rd, Suite 110, Austin, TX 78759-2327 |
| Find all physicians in zip 78759 | |||
| City | AUSTIN |
| Zip Code | 78759 |
| Specialty | PHYSICIAN ASSISTANT |
| City + Specialty | AUSTIN + PHYSICIAN ASSISTANT |
Please comment or provide details below to improve the information on Brooke Marie Stidham.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.