MEDICARE: STEPHEN M WALKER OPA-C

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	363A00000X	Physician Assistant	749	TX

General Provider Information

NPI Number	:	1730172875
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEPHEN M WALKER OPA-C

Provider Business Mailing Address
First Line	:	PO BOX 938
Second Line	:
City	:	ROWLETT
State	:	TX
Zip	:	75030-0938
Country	:	US
Telephone Number	:	214-227-2457
Fax Number	:	214-764-0880

Provider Business Practice Location Address
First Line	:	3509 BREWSTER DR
Second Line	:
City	:	PLANO
State	:	TX
Zip	:	75025-4445
Country	:	US
Telephone Number	:	214-227-2457
Fax Number	:	214-764-0880

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

Provider Enumeration Date	:	08/24/2005
Last Update Date	:	02/20/2020

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