Healthcare Provider Details

I. General information

NPI: 1144707886
Provider Name (Legal Business Name): AARON STEPHENSON OD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/25/2018
Last Update Date: 07/25/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6565 WEST LOOP S STE 650
BELLAIRE TX
77401-3505
US

IV. Provider business mailing address

6565 WEST LOOP S STE 650
BELLAIRE TX
77401-3505
US

V. Phone/Fax

Practice location:
  • Phone: 713-797-1010
  • Fax: 713-357-7290
Mailing address:
  • Phone: 713-797-1010
  • Fax: 713-357-7290

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number9465T
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: