Provider Demographics
NPI:1275299380
Name:STEVES, ROY RICHARD
Entity Type:Individual
Prefix:
First Name:ROY
Middle Name:RICHARD
Last Name:STEVES
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17635 HENDERSON PASS APT 721
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78232-1577
Mailing Address - Country:US
Mailing Address - Phone:210-725-1085
Mailing Address - Fax:
Practice Address - Street 1:17635 HENDERSON PASS APT 721
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78232-1577
Practice Address - Country:US
Practice Address - Phone:210-725-1085
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-12
Last Update Date:2021-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
208564224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXCNH4010303OtherCOUMBIA