Provider Demographics
NPI:1518063023
Name:DAY, STEPHEN VICTOR (DPM)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:VICTOR
Last Name:DAY
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1610 JAMES BOWIE DR
Mailing Address - Street 2:SUITE A102
Mailing Address - City:BAYTOWN
Mailing Address - State:TX
Mailing Address - Zip Code:77520-3357
Mailing Address - Country:US
Mailing Address - Phone:281-427-1802
Mailing Address - Fax:281-427-3664
Practice Address - Street 1:1610 JAMES BOWIE DR
Practice Address - Street 2:SUITE A102
Practice Address - City:BAYTOWN
Practice Address - State:TX
Practice Address - Zip Code:77520-3357
Practice Address - Country:US
Practice Address - Phone:281-427-1802
Practice Address - Fax:281-427-3664
Is Sole Proprietor?:No
Enumeration Date:2006-09-15
Last Update Date:2011-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDP0934213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX092796403Medicaid
8756N1Medicare ID - Type Unspecified
TX092796403Medicaid