Provider Demographics
NPI:1083767347
Name:FERENCE, STEPHEN WAYNE (OD)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:WAYNE
Last Name:FERENCE
Suffix:
Gender:M
Credentials:OD
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Mailing Address - Street 1:1101 MELBOURNE NO EAST MALL #5060
Mailing Address - Street 2:#5060
Mailing Address - City:HURST
Mailing Address - State:TX
Mailing Address - Zip Code:76053
Mailing Address - Country:US
Mailing Address - Phone:817-590-2022
Mailing Address - Fax:817-595-0366
Practice Address - Street 1:1101 MELBOURNE NO EAST MALL
Practice Address - Street 2:SUITE 5060
Practice Address - City:HURST
Practice Address - State:TX
Practice Address - Zip Code:76053
Practice Address - Country:US
Practice Address - Phone:817-590-2022
Practice Address - Fax:817-595-0366
Is Sole Proprietor?:No
Enumeration Date:2007-01-19
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TX3782TB152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist