Provider Demographics
NPI:1710180245
Name:R STEVENS GROUP
Entity Type:Organization
Organization Name:R STEVENS GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:EUGENE
Authorized Official - Last Name:STEVENS
Authorized Official - Suffix:JR
Authorized Official - Credentials:DDS
Authorized Official - Phone:281-328-4846
Mailing Address - Street 1:PO BOX 488
Mailing Address - Street 2:5909 FM 2100
Mailing Address - City:CROSBY
Mailing Address - State:TX
Mailing Address - Zip Code:77532
Mailing Address - Country:US
Mailing Address - Phone:281-328-4846
Mailing Address - Fax:281-328-5605
Practice Address - Street 1:5909 FM 2100
Practice Address - Street 2:
Practice Address - City:CROSBY
Practice Address - State:TX
Practice Address - Zip Code:77532
Practice Address - Country:US
Practice Address - Phone:281-328-4846
Practice Address - Fax:281-328-5605
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-11
Last Update Date:2008-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX21672122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty