Provider Demographics
NPI:1295051274
Name:HARTMAN, STACI DIANE (DO)
Entity type:Individual
Prefix:DR
First Name:STACI
Middle Name:DIANE
Last Name:HARTMAN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 CAMINO SANTA MARIA ST
Mailing Address - Street 2:STUDENT PSYCHOLOGICAL AND TESTING SERVICES
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78228-5433
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1 CAMINO SANTA MARIA ST
Practice Address - Street 2:STUDENT PSYCHOLOGICAL AND TESTING SERVICES
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78228-5433
Practice Address - Country:US
Practice Address - Phone:210-436-3135
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-04-15
Last Update Date:2015-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program