Healthcare Provider Details

I. General information

NPI: 1699954172
Provider Name (Legal Business Name): STEPHEN ALEXANDER IRWIN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/31/2007
Last Update Date: 05/07/2026
Certification Date: 05/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3702 W SOUTHERN HILLS BLVD
ROGERS AR
72758-8041
US

IV. Provider business mailing address

9330 LBJ FWY STE 800
DALLAS TX
75243-4310
US

V. Phone/Fax

Practice location:
  • Phone: 972-792-5700
  • Fax: 214-506-1170
Mailing address:
  • Phone: 972-792-5700
  • Fax: 214-506-1170

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License NumberE-6777
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: