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General NPI Number Information
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NPI Number | 1164803375
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Entity Type | Individual
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Provider Name | NICHOLAS PATRICK STETKEVICH D.O.
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Gender | Male
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Dates
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Enumeration Date | 06/12/2015
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Last Update Date | 08/19/2025
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Provider Practice Location Address
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Address Line | 15400 SOUTHWEST FWY STE 100
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City | SUGAR LAND
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State | TX
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Zip | 77478-3876
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Country | US
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Telephone | 281-494-7010
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Fax | 832-825-3689
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Provider Business Mailing Address
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Address Line | 2212 W HOLCOMBE BLVD
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City | HOUSTON
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State | TX
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Zip | 77030-2088
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Country | US
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Telephone | 408-355-0924
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 007585
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | S6061
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 2080S0010X
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Taxonomy Name | Pediatric Sports Medicine Physician
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License Number | S6061
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License Number State | TX
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