Healthcare Provider Details

I. General information

NPI: 1063540409
Provider Name (Legal Business Name): STEPHEN KENT CARPENTER BCHIS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/28/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8900 VISCOUNT BLVD A-M
EL PASO TX
79925-5897
US

IV. Provider business mailing address

8900 VISCOUNT BLVD A-M
EL PASO TX
79925-5897
US

V. Phone/Fax

Practice location:
  • Phone: 915-598-7777
  • Fax: 915-598-0341
Mailing address:
  • Phone: 915-598-7777
  • Fax: 915-598-0341

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number50336
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: