Healthcare Provider Details

I. General information

NPI: 1457533838
Provider Name (Legal Business Name): STEVEN J STANTON
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/28/2007
Last Update Date: 05/27/2020
Certification Date: 05/27/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9740 BARKER CYPRESS RD STE 108B
CYPRESS TX
77433-7886
US

IV. Provider business mailing address

9740 BARKER CYPRESS RD STE 108B
CYPRESS TX
77433-7886
US

V. Phone/Fax

Practice location:
  • Phone: 281-550-3338
  • Fax: 281-550-3436
Mailing address:
  • Phone: 281-550-3338
  • Fax: 281-550-3436

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number1673
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code213EP1101X
TaxonomyPrimary Podiatric Medicine Podiatrist
License Number1673
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number1673
License Number StateTX

VIII. Authorized Official

Name: DR. STEVEN J STANTON
Title or Position: SOLE PROPRIETOR
Credential: DPM
Phone: 281-550-3338