Provider Demographics
NPI:1457480055
Name:COLE, STEVEN LARRY (DO)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:LARRY
Last Name:COLE
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9101 N CENTRAL EXPY
Mailing Address - Street 2:430
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75231-5927
Mailing Address - Country:US
Mailing Address - Phone:214-363-8889
Mailing Address - Fax:214-363-9416
Practice Address - Street 1:9101 N CENTRAL EXPY
Practice Address - Street 2:SUITE 430
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-5927
Practice Address - Country:US
Practice Address - Phone:214-363-8889
Practice Address - Fax:214-363-9416
Is Sole Proprietor?:No
Enumeration Date:2007-03-02
Last Update Date:2023-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS 9346207RA0201X
TXL4312207RA0201X, 207KA0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207KA0200XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyAllergy
No207RA0201XAllopathic & Osteopathic PhysiciansInternal MedicineAllergy & Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX159026701Medicaid
TX159026701Medicaid
TX8A8748Medicare ID - Type Unspecified