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General NPI Number Information
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NPI Number | 1265604664
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Entity Type | Organization
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Legal Business Name | STEPHEN B. TRAMMELL, DO, PA
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Dates
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Enumeration Date | 03/26/2008
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Last Update Date | 02/13/2015
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Provider Practice Location Address
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Address Line | 675 W MAIN ST
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City | OVILLA
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State | TX
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Zip | 75154-1669
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Country | US
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Telephone | 972-617-6376
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Fax | 972-617-6381
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Provider Business Mailing Address
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Address Line | 675 W MAIN ST
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City | OVILLA
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State | TX
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Zip | 75154-1669
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Country | US
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Telephone | 972-617-6376
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Fax | 972-617-6381
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Authorized Official
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Title or Position | CLINIC DIRECTOR
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Name | STEPHANY TRAMMELL
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Credential |
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Telephone | 972-617-6376
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | H4751
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License Number State | TX
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