Provider Demographics
NPI:1891101549
Name:STEPHENS, NANCY ESTER (OD)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:ESTER
Last Name:STEPHENS
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:555 E MEDICAL CENTER BLVD STE 101
Mailing Address - Street 2:
Mailing Address - City:WEBSTER
Mailing Address - State:TX
Mailing Address - Zip Code:77598-4367
Mailing Address - Country:US
Mailing Address - Phone:281-488-7213
Mailing Address - Fax:281-488-1387
Practice Address - Street 1:11550 FUQUA ST
Practice Address - Street 2:SUITE 250
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77034-4599
Practice Address - Country:US
Practice Address - Phone:281-488-7213
Practice Address - Fax:281-669-3602
Is Sole Proprietor?:No
Enumeration Date:2014-07-02
Last Update Date:2015-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX8391TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX389554ZJOXOtherMEDICARE PTAN BRAZORIA
TX342128101Medicaid
TX389554ZJOYOtherMEDICARE PTAN GALVESTON
TX84732QOtherBCBS
TX389554YKZ2Medicare PIN