Provider Demographics
NPI:1114981727
Name:LIEMAN, STEPHEN J (MD)
Entity Type:Individual
Prefix:MR
First Name:STEPHEN
Middle Name:J
Last Name:LIEMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5300 W PLANO PKWY STE 200
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-4861
Mailing Address - Country:US
Mailing Address - Phone:972-612-8037
Mailing Address - Fax:972-867-6049
Practice Address - Street 1:5300 W PLANO PKWY
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-4821
Practice Address - Country:US
Practice Address - Phone:972-612-8037
Practice Address - Fax:972-867-6049
Is Sole Proprietor?:No
Enumeration Date:2006-04-12
Last Update Date:2008-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF5620208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX098625901Medicaid
TX87M731Medicare ID - Type Unspecified
TXB24387Medicare UPIN