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Contact Information

JAMES S DISTEFANO, DO
3201 UNIVERSITY DR E STE 320
BRYAN, TX77802-3478
 Phone: 979-704-5029
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Sports Medicine

207PS0010X 93 Physician/Emergency Medicine
Indicates primary specialty

NPI Profile & details for JAMES S DISTEFANO · (Male)

NPI # 1457324782
Status Active
Credentials DO (Doctor of Osteopathic)
Entity Individual
Enumeration date 02/08/2006
Last updated 10/10/2018 - About 8 years ago
Sole proprietor 1 No
Identifiers
  • TX License # M7149
  • Other 8AH949 BLUE CROSS
Hospital affiliation(s)
  • MADISON ST JOSEPH HEALTH CENTER - (Critical Access)
    100 WEST CROSS STREET
    MADISONVILLE, TX 77864
  • PHYSICIANS CENTRETHE - (Acute Care)
    3131 UNIVERSITY DRIVE EAST
    BRYAN, TX 77802
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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