Provider Demographics
NPI:1801930268
Name:STEVENSON, ANNE ELIZABETH (OD)
Entity type:Individual
Prefix:
First Name:ANNE
Middle Name:ELIZABETH
Last Name:STEVENSON
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6510 ABRAMS RD STE 500
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75231-8344
Mailing Address - Country:US
Mailing Address - Phone:214-348-9500
Mailing Address - Fax:214-348-9511
Practice Address - Street 1:6510 ABRAMS RD STE 500
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-8344
Practice Address - Country:US
Practice Address - Phone:214-348-9500
Practice Address - Fax:214-348-9511
Is Sole Proprietor?:No
Enumeration Date:2007-02-19
Last Update Date:2023-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX3584-T152W00000X
TX3584T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXT16117Medicare UPIN
TX8F6391Medicare PIN