Provider Demographics
NPI:1215404942
Name:STEPHENS FAMILY HEALTHCARE INC
Entity Type:Organization
Organization Name:STEPHENS FAMILY HEALTHCARE INC
Other - Org Name:ST. STEPHENS FAMILY CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ALEXANDER-P
Authorized Official - Middle Name:IKE
Authorized Official - Last Name:STEPHENS
Authorized Official - Suffix:
Authorized Official - Credentials:FNP-BC
Authorized Official - Phone:832-740-4107
Mailing Address - Street 1:2912A MANGUM RD
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77092-7408
Mailing Address - Country:US
Mailing Address - Phone:832-740-4107
Mailing Address - Fax:832-530-4905
Practice Address - Street 1:2912A MANGUM RD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77092-7408
Practice Address - Country:US
Practice Address - Phone:832-740-4107
Practice Address - Fax:832-530-4905
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-31
Last Update Date:2018-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care