Provider Demographics
NPI:1972659688
Name:STIEN, JON ANTHONY (PA-C)
Entity Type:Individual
Prefix:MR
First Name:JON
Middle Name:ANTHONY
Last Name:STIEN
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Gender:M
Credentials:PA-C
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Mailing Address - Street 1:2727 BOLTON BOONE DR
Mailing Address - Street 2:#103
Mailing Address - City:DESOTO
Mailing Address - State:TX
Mailing Address - Zip Code:75115-2019
Mailing Address - Country:US
Mailing Address - Phone:972-296-7200
Mailing Address - Fax:972-296-7206
Practice Address - Street 1:2727 BOLTON BOONE DR
Practice Address - Street 2:#103
Practice Address - City:DESOTO
Practice Address - State:TX
Practice Address - Zip Code:75115-2019
Practice Address - Country:US
Practice Address - Phone:972-296-7200
Practice Address - Fax:972-296-7206
Is Sole Proprietor?:No
Enumeration Date:2007-01-26
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXPA03698363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant