Provider Demographics
NPI:1073988762
Name:BIANES, STEPHEN (PT)
Entity Type:Individual
Prefix:MR
First Name:STEPHEN
Middle Name:
Last Name:BIANES
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4375 N MAJOR DR
Mailing Address - Street 2:1614
Mailing Address - City:BEAUMONT
Mailing Address - State:TX
Mailing Address - Zip Code:77713-8816
Mailing Address - Country:US
Mailing Address - Phone:409-434-7689
Mailing Address - Fax:
Practice Address - Street 1:4375 N MAJOR DR
Practice Address - Street 2:APARTMENT 1614
Practice Address - City:BEAUMONT
Practice Address - State:TX
Practice Address - Zip Code:77713-8816
Practice Address - Country:US
Practice Address - Phone:409-434-7689
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-06
Last Update Date:2015-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1221126225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist