Provider Demographics
NPI:1932531779
Name:WIMAN, STEPHANIE ELIZABETH (MD)
Entity Type:Individual
Prefix:DR
First Name:STEPHANIE
Middle Name:ELIZABETH
Last Name:WIMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:STEPHANIE
Other - Middle Name:WIMAN
Other - Last Name:WELLS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:9235 KATY FWY STE 400
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77024-1507
Mailing Address - Country:US
Mailing Address - Phone:713-461-2915
Mailing Address - Fax:713-461-5307
Practice Address - Street 1:9436 N HOUSTON ROSSLYN RD STE C
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77088-3905
Practice Address - Country:US
Practice Address - Phone:713-461-2915
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-03
Last Update Date:2019-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ8831207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
1932531779OtherNPI
1932531779OtherNPI