Provider Demographics
NPI:1265491591
Name:STEPP, RAYMOND W (O D)
Entity Type:Individual
Prefix:DR
First Name:RAYMOND
Middle Name:W
Last Name:STEPP
Suffix:
Gender:M
Credentials:O D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 543
Mailing Address - Street 2:
Mailing Address - City:COMANCHE
Mailing Address - State:TX
Mailing Address - Zip Code:76442-0543
Mailing Address - Country:US
Mailing Address - Phone:325-356-5246
Mailing Address - Fax:325-356-5247
Practice Address - Street 1:406 N AUSTIN ST
Practice Address - Street 2:
Practice Address - City:COMANCHE
Practice Address - State:TX
Practice Address - Zip Code:76442-2408
Practice Address - Country:US
Practice Address - Phone:325-356-3266
Practice Address - Fax:325-356-5247
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-23
Last Update Date:2008-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2182TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX093286501Medicaid
TX270775OtherSCOTT & WHITE
TX093286501Medicaid
TX00E52HMedicare ID - Type Unspecified
TX0240730001Medicare NSC
TX270775OtherSCOTT & WHITE