Provider Demographics
NPI:1033364997
Name:STEPHENSON, PAUL GREGORY (MS, F-AAA)
Entity Type:Individual
Prefix:MR
First Name:PAUL
Middle Name:GREGORY
Last Name:STEPHENSON
Suffix:
Gender:M
Credentials:MS, F-AAA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2800 W HIGGINS RD
Mailing Address - Street 2:SUITE 895
Mailing Address - City:HOFFMAN ESTATES
Mailing Address - State:IL
Mailing Address - Zip Code:60169-2071
Mailing Address - Country:US
Mailing Address - Phone:847-843-1900
Mailing Address - Fax:847-843-1901
Practice Address - Street 1:811 NE ALSBURY BLVD
Practice Address - Street 2:SUITE 900
Practice Address - City:BURLESON
Practice Address - State:TX
Practice Address - Zip Code:76028-2668
Practice Address - Country:US
Practice Address - Phone:817-426-4318
Practice Address - Fax:817-426-0127
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-19
Last Update Date:2014-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX50572231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist