MEDICARE: STEVE VINCENT ESTOY FORDAN MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RE0101X	Endocrinology, Diabetes & Metabolism Physician	M3223	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	8CA477	OTHER	TX	BLUE CROSS/BLUE SHIELD

General Provider Information

NPI Number	:	1245432582
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEVE VINCENT ESTOY FORDAN MD

Provider Business Mailing Address
First Line	:	1018 N ZANG BLVD STE 110
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75208-4123
Country	:	US
Telephone Number	:	214-412-2160
Fax Number	:	972-427-5151

Provider Business Practice Location Address
First Line	:	1018 N ZANG BLVD STE 110
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75208-4123
Country	:	US
Telephone Number	:	972-266-8765
Fax Number	:	972-266-5511

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/31/2007
Last Update Date	:	07/10/2025

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