Provider Demographics
NPI:1457374142
Name:COHEN, STEPHEN C (MD)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:C
Last Name:COHEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2130 N.E.LOOP 410
Mailing Address - Street 2:SUITE #250
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78217-4660
Mailing Address - Country:US
Mailing Address - Phone:210-590-8206
Mailing Address - Fax:210-590-8251
Practice Address - Street 1:2130 N.E.LOOP 410
Practice Address - Street 2:SUITE #250
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78217-4660
Practice Address - Country:US
Practice Address - Phone:210-590-8206
Practice Address - Fax:210-590-8251
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2009-11-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXE3883207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8F22908Medicare PIN