Provider Demographics
NPI:1902007842
Name:TERAUCHI, STEPHANIE YUKO (MD)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:YUKO
Last Name:TERAUCHI
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:TEXAS ONCOLOGY PHYSICIAN ASSOCIATES
Mailing Address - Street 2:10425 N CENTRAL EXPRESSWAY
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75231-7208
Mailing Address - Country:US
Mailing Address - Phone:214-361-2025
Mailing Address - Fax:143-612-0282
Practice Address - Street 1:TEXAS ONCOLOGY PHYSICIAN ASSOCIATES
Practice Address - Street 2:10425 N CENTRAL EXPRESSWAY
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-7208
Practice Address - Country:US
Practice Address - Phone:214-361-2025
Practice Address - Fax:214-361-2028
Is Sole Proprietor?:No
Enumeration Date:2007-05-29
Last Update Date:2024-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM9048208M00000X, 207R00000X, 207RH0002X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1945156-02Medicaid
TX1945156-02Medicaid