Provider Demographics
NPI:1396793493
Name:STEVENS, JONATHAN R (MD, MPH)
Entity type:Individual
Prefix:DR
First Name:JONATHAN
Middle Name:R
Last Name:STEVENS
Suffix:
Gender:M
Credentials:MD, MPH
Other - Prefix:
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Mailing Address - Street 1:19 BRIAR HOLLOW LN
Mailing Address - Street 2:SUITE 120
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77027
Mailing Address - Country:US
Mailing Address - Phone:844-746-7444
Mailing Address - Fax:866-502-3265
Practice Address - Street 1:19 BRIAR HOLLOW LN
Practice Address - Street 2:SUITE 120
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77027
Practice Address - Country:US
Practice Address - Phone:844-746-7444
Practice Address - Fax:866-502-3265
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-04
Last Update Date:2022-07-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA2278052084P0800X
FLME1568392084P0800X, 2084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry