Provider Demographics
NPI:1811060411
Name:STEPHENS, NANETTE S (PHD)
Entity type:Individual
Prefix:DR
First Name:NANETTE
Middle Name:S
Last Name:STEPHENS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24 GREENWAY PLAZA
Mailing Address - Street 2:SUITE 1703
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77046
Mailing Address - Country:US
Mailing Address - Phone:713-790-1330
Mailing Address - Fax:713-961-5019
Practice Address - Street 1:24 GREENWAY PLAZA
Practice Address - Street 2:SUITE 1703
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77046
Practice Address - Country:US
Practice Address - Phone:713-790-1330
Practice Address - Fax:713-961-5019
Is Sole Proprietor?:No
Enumeration Date:2006-11-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX25479103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00S4BGOtherBCBS
TX86402AOtherBCBS