Provider Demographics
NPI:1942418595
Name:STEVENS, ROBERT EUGENE JR (DDS)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:EUGENE
Last Name:STEVENS
Suffix:JR
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O.BOX 488
Mailing Address - Street 2:
Mailing Address - City:CROSBY
Mailing Address - State:TX
Mailing Address - Zip Code:77532
Mailing Address - Country:US
Mailing Address - Phone:281-328-4846
Mailing Address - Fax:281-328-5606
Practice Address - Street 1:5909 FM 2100
Practice Address - Street 2:
Practice Address - City:CROSBY
Practice Address - State:TX
Practice Address - Zip Code:77532
Practice Address - Country:US
Practice Address - Phone:281-328-4846
Practice Address - Fax:281-328-5606
Is Sole Proprietor?:No
Enumeration Date:2007-05-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX213721223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice