Provider Demographics
NPI:1639197759
Name:ADDINGTON, STEFANIE LYNN (MD)
Entity Type:Individual
Prefix:
First Name:STEFANIE
Middle Name:LYNN
Last Name:ADDINGTON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6124 W PARKER RD STE 234
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-8124
Mailing Address - Country:US
Mailing Address - Phone:729-468-9999
Mailing Address - Fax:972-981-3600
Practice Address - Street 1:8350 DALLAS PKWY STE 300
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75034-5076
Practice Address - Country:US
Practice Address - Phone:972-468-9999
Practice Address - Fax:972-981-3600
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2023-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL8255207RE0101X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX166136503Medicaid
TX166136503Medicaid
I05258Medicare UPIN
I05258Medicare UPIN
TX166136501Medicaid