Provider Demographics
NPI:1205099280
Name:STOUT, STEVEN DANIEL (BCHIS)
Entity type:Individual
Prefix:MR
First Name:STEVEN
Middle Name:DANIEL
Last Name:STOUT
Suffix:
Gender:M
Credentials:BCHIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1505 BEVERLY DR
Mailing Address - Street 2:
Mailing Address - City:WICHITA FALLS
Mailing Address - State:TX
Mailing Address - Zip Code:76309-2124
Mailing Address - Country:US
Mailing Address - Phone:940-723-4200
Mailing Address - Fax:940-723-4203
Practice Address - Street 1:1505 BEVERLY DR
Practice Address - Street 2:
Practice Address - City:WICHITA FALLS
Practice Address - State:TX
Practice Address - Zip Code:76309-2124
Practice Address - Country:US
Practice Address - Phone:940-723-4200
Practice Address - Fax:940-723-4203
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-09
Last Update Date:2021-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX50571237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist