Provider Demographics
NPI:1043214919
Name:STANTON, STEVEN J
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:J
Last Name:STANTON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9740 BARKER CYPRESS RD STE 108B
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77433-7886
Mailing Address - Country:US
Mailing Address - Phone:281-550-3338
Mailing Address - Fax:281-550-3436
Practice Address - Street 1:9740 BARKER CYPRESS RD STE 108B
Practice Address - Street 2:
Practice Address - City:CYPRESS
Practice Address - State:TX
Practice Address - Zip Code:77433-7886
Practice Address - Country:US
Practice Address - Phone:281-550-3338
Practice Address - Fax:281-550-3436
Is Sole Proprietor?:No
Enumeration Date:2005-06-09
Last Update Date:2021-12-20
Deactivation Date:2006-03-15
Deactivation Code:
Reactivation Date:2006-04-03
Provider Licenses
StateLicense IDTaxonomies
TX1673213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8AJ844OtherBCBS TX
TX168419301Medicaid
TXP00186878OtherRAILROAD MEDICARE
TX5060770001Medicare NSC
TX610422Medicare PIN
TXP00186878OtherRAILROAD MEDICARE