Provider Demographics
NPI:1194178459
Name:STEPHENS, ALEXANDER-P IKE (FNP-BC)
Entity Type:Individual
Prefix:
First Name:ALEXANDER-P
Middle Name:IKE
Last Name:STEPHENS
Suffix:
Gender:M
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6515 CANYON ESTATES LN
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77469-6109
Mailing Address - Country:US
Mailing Address - Phone:832-208-0250
Mailing Address - Fax:
Practice Address - Street 1:6515 CANYON ESTATES LN
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77469-6109
Practice Address - Country:US
Practice Address - Phone:832-208-0250
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-21
Last Update Date:2016-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP131079363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily