Provider Demographics
NPI:1609237320
Name:DYKALSKI, STEPHANIE ANN (NP)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:ANN
Last Name:DYKALSKI
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:11609 SPRING CYPRESS RD
Mailing Address - Street 2:UNIT C
Mailing Address - City:TOMBALL
Mailing Address - State:TX
Mailing Address - Zip Code:77377-8917
Mailing Address - Country:US
Mailing Address - Phone:281-290-6300
Mailing Address - Fax:281-290-6302
Practice Address - Street 1:11609 SPRING CYPRESS RD
Practice Address - Street 2:UNIT C
Practice Address - City:TOMBALL
Practice Address - State:TX
Practice Address - Zip Code:77377-8917
Practice Address - Country:US
Practice Address - Phone:281-290-6300
Practice Address - Fax:281-290-6302
Is Sole Proprietor?:No
Enumeration Date:2016-03-08
Last Update Date:2016-03-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXAP130016363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner