Provider Demographics
NPI:1457643074
Name:ASFAR, STEPHANIE LYNN (AUD)
Entity Type:Individual
Prefix:MRS
First Name:STEPHANIE
Middle Name:LYNN
Last Name:ASFAR
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:MISS
Other - First Name:STEPHANIE
Other - Middle Name:LYNN
Other - Last Name:ANDERSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:AUD
Mailing Address - Street 1:4105 W. SPRING CREEK PARKWAY
Mailing Address - Street 2:SUITE 702
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75024-5301
Mailing Address - Country:US
Mailing Address - Phone:972-943-0466
Mailing Address - Fax:972-599-1707
Practice Address - Street 1:4105 W. SPRING CREEK PARKWAY
Practice Address - Street 2:SUITE 702
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75024-5301
Practice Address - Country:US
Practice Address - Phone:972-943-0466
Practice Address - Fax:972-599-1707
Is Sole Proprietor?:No
Enumeration Date:2011-05-15
Last Update Date:2017-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX80322231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXTXB163211Medicare UPIN