Provider Demographics
NPI:1184678708
Name:STEIN-GOLDINGS, AUDREY STEIN (MD)
Entity Type:Individual
Prefix:DR
First Name:AUDREY
Middle Name:STEIN
Last Name:STEIN-GOLDINGS
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 1:1151 N BUCKNER
Mailing Address - Street 2:STE 101
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75218
Mailing Address - Country:US
Mailing Address - Phone:214-324-9354
Mailing Address - Fax:214-327-3547
Practice Address - Street 1:1151 N BUCKNER BLVD
Practice Address - Street 2:STE 101
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75218-3426
Practice Address - Country:US
Practice Address - Phone:214-324-9354
Practice Address - Fax:214-327-3547
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-19
Last Update Date:2012-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF84912084N0400X
TX84912084N0400X, 2084S0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No2084S0012XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologySleep Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1000036-01Medicaid
B23052Medicare UPIN
TX1000036-01Medicaid
TXTXB104809Medicare PIN
TXRR64Medicare ID - Type Unspecified