Provider Demographics
NPI:1518224898
Name:TIPTON, STEPHANIE MEGAN (DO)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:MEGAN
Last Name:TIPTON
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6507 S COOPER ST STE 105
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76001-5818
Mailing Address - Country:US
Mailing Address - Phone:817-466-9100
Mailing Address - Fax:817-466-9410
Practice Address - Street 1:6507 S COOPER ST STE 105
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76001-5818
Practice Address - Country:US
Practice Address - Phone:817-466-9100
Practice Address - Fax:817-466-9410
Is Sole Proprietor?:No
Enumeration Date:2012-04-11
Last Update Date:2022-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX565832207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine