Provider Demographics
NPI:1578655320
Name:STEPHENSON, ROBIN LEIGH (DC)
Entity Type:Individual
Prefix:DR
First Name:ROBIN
Middle Name:LEIGH
Last Name:STEPHENSON
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11161 SUMAC RD
Mailing Address - Street 2:
Mailing Address - City:GILMER
Mailing Address - State:TX
Mailing Address - Zip Code:75644-5886
Mailing Address - Country:US
Mailing Address - Phone:903-918-4507
Mailing Address - Fax:
Practice Address - Street 1:11161 SUMAC RD
Practice Address - Street 2:
Practice Address - City:GILMER
Practice Address - State:TX
Practice Address - Zip Code:75644-5886
Practice Address - Country:US
Practice Address - Phone:903-918-4507
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-29
Last Update Date:2023-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10403111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXTXB124886Medicare PIN