=====================================================
General NPI Number Information
=====================================================
NPI Number | 1215207428
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MALIA LINDA STEPHENSON CRNA
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/04/2012
-----------------------------------------------------
Last Update Date | 12/20/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 12222 N CENTRAL EXPY STE 340
-----------------------------------------------------
City | DALLAS
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75243-3755
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 972-972-4851
-----------------------------------------------------
Fax | 972-556-5202
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1540 KELLER PKWY STE 108-429
-----------------------------------------------------
City | KELLER
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 76248-3686
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 972-771-2011
-----------------------------------------------------
Fax | 877-292-3457
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 367500000X
-----------------------------------------------------
Taxonomy Name | Certified Registered Nurse Anesthetist
-----------------------------------------------------
License Number | 104379
-----------------------------------------------------
License Number State | OK
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 367500000X
-----------------------------------------------------
Taxonomy Name | Certified Registered Nurse Anesthetist
-----------------------------------------------------
License Number | 828628
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------