Provider Demographics
NPI:1821155334
Name:OPERSTENY, STEVE C (MD)
Entity Type:Individual
Prefix:
First Name:STEVE
Middle Name:C
Last Name:OPERSTENY
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 1:3201 UNIVERSITY PR. E.
Mailing Address - Street 2:SUITE 160
Mailing Address - City:BRYAN
Mailing Address - State:TX
Mailing Address - Zip Code:77802
Mailing Address - Country:US
Mailing Address - Phone:979-704-5409
Mailing Address - Fax:979-704-5410
Practice Address - Street 1:3201 UNIVERSITY PR. E.
Practice Address - Street 2:SUITE 160
Practice Address - City:BRYAN
Practice Address - State:TX
Practice Address - Zip Code:77802
Practice Address - Country:US
Practice Address - Phone:979-704-5409
Practice Address - Fax:979-704-5410
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-03
Last Update Date:2019-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH2657208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX120319-02Medicaid
TX120319202Medicaid