Provider Demographics
NPI:1912228974
Name:STANFORD, STEVEN MICHAEL (DPT)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:MICHAEL
Last Name:STANFORD
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:605 ROCKMEAD DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:KINGWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:77339-2254
Mailing Address - Country:US
Mailing Address - Phone:281-348-9588
Mailing Address - Fax:281-348-2150
Practice Address - Street 1:605 ROCKMEAD DR
Practice Address - Street 2:SUITE 200
Practice Address - City:KINGWOOD
Practice Address - State:TX
Practice Address - Zip Code:77339-2254
Practice Address - Country:US
Practice Address - Phone:281-348-9588
Practice Address - Fax:281-348-2150
Is Sole Proprietor?:No
Enumeration Date:2010-06-14
Last Update Date:2018-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1196910225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist