Provider Demographics
NPI:1376704973
Name:TRAHAN, STEPHEN GEORGE (DDS)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:GEORGE
Last Name:TRAHAN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1780 S FRIENDSWOOD DR
Mailing Address - Street 2:SUITE A
Mailing Address - City:FRIENDSWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:77546
Mailing Address - Country:US
Mailing Address - Phone:281-992-0038
Mailing Address - Fax:281-993-5161
Practice Address - Street 1:1780 S FRIENDSWOOD DR
Practice Address - Street 2:SUITE A
Practice Address - City:FRIENDSWOOD
Practice Address - State:TX
Practice Address - Zip Code:77546
Practice Address - Country:US
Practice Address - Phone:281-992-0038
Practice Address - Fax:281-993-5161
Is Sole Proprietor?:No
Enumeration Date:2008-06-17
Last Update Date:2015-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX288471223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice