Provider Demographics
NPI:1457574576
Name:FLEMING, STEPHANIE HELM (OD)
Entity Type:Individual
Prefix:DR
First Name:STEPHANIE
Middle Name:HELM
Last Name:FLEMING
Suffix:
Gender:F
Credentials:OD
Other - Prefix:DR
Other - First Name:STEPHANIE
Other - Middle Name:SUZANNE
Other - Last Name:HELM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:5442 LA SIERRA DR
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75231-4108
Mailing Address - Country:US
Mailing Address - Phone:214-828-9900
Mailing Address - Fax:214-828-9900
Practice Address - Street 1:5442 LA SIERRA DR
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-4108
Practice Address - Country:US
Practice Address - Phone:214-828-9900
Practice Address - Fax:214-828-9900
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-10
Last Update Date:2021-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX5703TG152WL0500X, 152W00000X
TX5703T152WL0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
No152WL0500XEye and Vision Services ProvidersOptometristLow Vision Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX038410901Medicaid
TX038410901Medicaid
TX66724OtherCSHCN
TX81149EMedicare ID - Type Unspecified