Provider Demographics
NPI:1821157199
Name:TROCME, STEFAN D (MD)
Entity Type:Individual
Prefix:
First Name:STEFAN
Middle Name:D
Last Name:TROCME
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:PO BOX 4439
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77210-4439
Mailing Address - Country:US
Mailing Address - Phone:713-792-2991
Mailing Address - Fax:
Practice Address - Street 1:1515 HOLCOMBE BLVD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-4000
Practice Address - Country:US
Practice Address - Phone:713-792-6161
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-06
Last Update Date:2015-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35089276207W00000X
TXH9725207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH4356995OtherAETNA
OH743255OtherBUCKEYE
OH415045OtherWELLCARE
OH000000209658OtherUNISON
OHP00412631OtherRAILROAD MEDICARE
OH000000511519OtherANTHEM
TX126462407Medicaid
OH2718054Medicaid
OHP00412631OtherRAILROAD MEDICARE
OH743255OtherBUCKEYE