Healthcare Provider Details

I. General information

NPI: 1801751706
Provider Name (Legal Business Name): KATHRYN GRACE STEPHENS PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/22/2025
Last Update Date: 05/07/2026
Certification Date: 05/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1401 MEDICAL PKWY STE 101
CEDAR PARK TX
78613-5012
US

IV. Provider business mailing address

8701 N MOPAC EXPY STE 105
AUSTIN TX
78759-8364
US

V. Phone/Fax

Practice location:
  • Phone: 512-788-9688
  • Fax: 512-260-1991
Mailing address:
  • Phone: 512-687-1970
  • Fax: 512-407-9010

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: