Provider Demographics
NPI:1740579721
Name:MORRICAL, STEPHEN OLIVER (MD)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:OLIVER
Last Name:MORRICAL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:901 HARBORSIDE DR
Mailing Address - Street 2:EMERGENCY DEPARTMENT
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77550
Mailing Address - Country:US
Mailing Address - Phone:409-772-1191
Mailing Address - Fax:
Practice Address - Street 1:901 HARBORSIDE DR
Practice Address - Street 2:
Practice Address - City:GALVESTON
Practice Address - State:TX
Practice Address - Zip Code:77550
Practice Address - Country:US
Practice Address - Phone:409-772-1161
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-30
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP9914207P00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program