MEDICARE: STEPHEN MARK OLMSTEAD, D.O., ALLERGY, ASTHMA & IMMUNOLOGY ASSOCIATES

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	174400000X	Specialist	J8336	TX

General Provider Information

NPI Number	:	1841389426
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	STEPHEN MARK OLMSTEAD, D.O., ALLERGY, ASTHMA & IMMUNOLOGY ASSOCIATES

Provider Business Mailing Address
First Line	:	7150 N PRESIDENT GEORGE BUSH HWY
Second Line	:	SUITE 204
City	:	GARLAND
State	:	TX
Zip	:	75044-2208
Country	:	US
Telephone Number	:	972-463-3406
Fax Number	:	972-412-6317

Provider Business Practice Location Address
First Line	:	7150 N PRESIDENT GEORGE BUSH HWY
Second Line	:	SUITE 204
City	:	GARLAND
State	:	TX
Zip	:	75044-2208
Country	:	US
Telephone Number	:	972-463-3406
Fax Number	:	972-412-6317

Authorized Official
Title or Position	:	CEO
Name	:	STEPHEN MARK OLMSTEAD
Credential	:	D.O.
Telephone Number	:	972-463-3406

Provider Enumeration Date	:	10/12/2006
Last Update Date	:	08/22/2020

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