Provider Demographics
NPI:1659364479
Name:KURTIN, STEVEN CHARLES (DO)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:CHARLES
Last Name:KURTIN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17051 N. DALLAS PARKWAY #175
Mailing Address - Street 2:
Mailing Address - City:ADDISON
Mailing Address - State:TX
Mailing Address - Zip Code:75001
Mailing Address - Country:US
Mailing Address - Phone:972-908-9999
Mailing Address - Fax:
Practice Address - Street 1:17051 N. DALLAS PARKWAY #175
Practice Address - Street 2:
Practice Address - City:ADDISON
Practice Address - State:TX
Practice Address - Zip Code:75001
Practice Address - Country:US
Practice Address - Phone:972-908-9999
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-26
Last Update Date:2016-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX3495TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
752151812OtherUNITED HEALTH CARE
752151812OtherPHCS PPO
752151812OtherHEALTH SMART
752151812OtherEYE CARE OF AMERICA
TX00E035OtherBCBS
752151812OtherVISION SERVICE PLAN
TX752151812OtherAETNA
TX752151812OtherAETNA
T79027Medicare UPIN