Provider Demographics
NPI:1134755051
Name:STEPHENS, WALTER DAVID II (MD)
Entity type:Individual
Prefix:DR
First Name:WALTER
Middle Name:DAVID
Last Name:STEPHENS
Suffix:II
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 1:206 GENE SAMFORD DR
Mailing Address - Street 2:
Mailing Address - City:LUFKIN
Mailing Address - State:TX
Mailing Address - Zip Code:75904-3358
Mailing Address - Country:US
Mailing Address - Phone:936-634-3396
Mailing Address - Fax:936-632-7933
Practice Address - Street 1:206 GENE SAMFORD DR
Practice Address - Street 2:
Practice Address - City:LUFKIN
Practice Address - State:TX
Practice Address - Zip Code:75904-3358
Practice Address - Country:US
Practice Address - Phone:936-634-3396
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-23
Last Update Date:2023-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXU6585207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine