Provider Demographics
NPI:1952918690
Name:ARIAS, STEFAN DEAN (NP)
Entity type:Individual
Prefix:
First Name:STEFAN
Middle Name:DEAN
Last Name:ARIAS
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5531 S HULEN ST
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76132-2202
Mailing Address - Country:US
Mailing Address - Phone:817-346-5960
Mailing Address - Fax:817-346-5961
Practice Address - Street 1:5531 S HULEN ST
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76132-2202
Practice Address - Country:US
Practice Address - Phone:817-346-5960
Practice Address - Fax:817-346-5961
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-27
Last Update Date:2022-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX935793163W00000X
TX1096902363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse