Provider Demographics
NPI:1730485418
Name:STEPHEN, GINA (MD)
Entity Type:Individual
Prefix:DR
First Name:GINA
Middle Name:
Last Name:STEPHEN
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 1:7900 FANNIN ST
Mailing Address - Street 2:SUITE 3300
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77054-2934
Mailing Address - Country:US
Mailing Address - Phone:713-630-0660
Mailing Address - Fax:
Practice Address - Street 1:7900 FANNIN ST
Practice Address - Street 2:SUITE 3300
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77054-2934
Practice Address - Country:US
Practice Address - Phone:713-630-0660
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-01-28
Last Update Date:2022-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP9980208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics