Provider Demographics
NPI:1609528983
Name:STEVENS, STEPHANIE FAYE
Entity Type:Individual
Prefix:MS
First Name:STEPHANIE
Middle Name:FAYE
Last Name:STEVENS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8740 WESTHEIMER RD APT 47
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77063-4236
Mailing Address - Country:US
Mailing Address - Phone:713-322-7065
Mailing Address - Fax:
Practice Address - Street 1:8740 WESTHEIMER RD APT 47
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77063-4236
Practice Address - Country:US
Practice Address - Phone:713-322-7065
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-19
Last Update Date:2022-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX13149586347C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347C00000XTransportation ServicesPrivate Vehicle