Provider Demographics
NPI:1114984903
Name:STEPHENS, ELENA VALERIE (MD)
Entity Type:Individual
Prefix:DR
First Name:ELENA
Middle Name:VALERIE
Last Name:STEPHENS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 WEST DEAN KEETON ST
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78712-7339
Mailing Address - Country:US
Mailing Address - Phone:512-475-8327
Mailing Address - Fax:512-323-7550
Practice Address - Street 1:100 WEST DEAN KEETON ST
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78712-7339
Practice Address - Country:US
Practice Address - Phone:512-475-8327
Practice Address - Fax:512-323-7550
Is Sole Proprietor?:No
Enumeration Date:2006-04-27
Last Update Date:2012-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL7197390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program