Healthcare Provider Details

I. General information

NPI: 1275712325
Provider Name (Legal Business Name): STEPHEN L. GRAHAM OF TEXAS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/25/2007
Last Update Date: 10/25/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

224 CHARLES ST
HUMBLE TX
77338-3842
US

IV. Provider business mailing address

224 CHARLES ST
HUMBLE TX
77338-3842
US

V. Phone/Fax

Practice location:
  • Phone: 281-446-4045
  • Fax:
Mailing address:
  • Phone: 281-446-4045
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number7073
License Number StateTX

VIII. Authorized Official

Name: DR. STEPHEN CHRISTOPHER STINNETT
Title or Position: OWNER
Credential: D.C.
Phone: 281-446-4045