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General NPI Number Information
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NPI Number | 1265624571
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Entity Type | Individual
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Provider Name | STEPHANIE LEE-BLANCHE CUDJOE M.D.
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Gender | Female
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Dates
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Enumeration Date | 08/10/2007
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Last Update Date | 05/19/2023
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Provider Practice Location Address
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Address Line | 8951 COLLIN MCKINNEY PKWY STE 502
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City | MCKINNEY
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State | TX
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Zip | 75070-8482
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Country | US
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Telephone | 972-214-8579
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Fax | 972-947-5284
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Provider Business Mailing Address
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Address Line | 8951 COLLIN MCKINNEY PKWY STE 502
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City | MCKINNEY
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State | TX
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Zip | 75070-8482
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Country | US
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Telephone | 972-214-8579
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Fax | 972-947-5284
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | M9942
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License Number State | TX
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