Provider Demographics
NPI:1255315107
Name:TRAWEEK, STEPHEN THOMAS (MD)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:THOMAS
Last Name:TRAWEEK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 2386
Mailing Address - Street 2:BRAZOS VALLEY PATHOLOGY
Mailing Address - City:ROUND ROCK
Mailing Address - State:TX
Mailing Address - Zip Code:78664
Mailing Address - Country:US
Mailing Address - Phone:512-431-8896
Mailing Address - Fax:512-597-2713
Practice Address - Street 1:201 SETON PARKWAY
Practice Address - Street 2:SETON MEDICAL CENTER WILLIAMSON
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78665
Practice Address - Country:US
Practice Address - Phone:512-814-0298
Practice Address - Fax:512-597-2713
Is Sole Proprietor?:No
Enumeration Date:2005-12-05
Last Update Date:2014-11-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NMTM2005-0460207ZP0102X
NC94-00376207ZP0102X
ORMD12833207ZP0102X
TXF7243207ZP0102X
ME016927207ZP0102X
MO2006002073207ZP0102X
NJ25MA08053300207ZP0102X
NY242155207ZP0102X
UT6274590-1205207ZP0102X
CAA43879207ZP0102X
CODR-41129207ZP0102X
AZ34627207ZP0102X
GA056777207ZP0102X
IL36114521207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX140908801Medicaid
TX8P1845OtherBCBS
TX8203M2Medicare ID - Type Unspecified
TXE96688Medicare UPIN
TX140908801Medicaid
TX8P1845OtherBCBS