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General NPI Number Information
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NPI Number | 1548857485
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Entity Type | Individual
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Provider Name | STEPHANIE D SCOTT CSFA
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Gender | Female
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Dates
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Enumeration Date | 12/27/2020
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Last Update Date | 06/23/2022
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Provider Practice Location Address
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Address Line | 1102 N GALLOWAY AVE
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City | MESQUITE
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State | TX
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Zip | 75149-2436
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Country | US
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Telephone | 469-518-7853
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Fax | 469-232-9917
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Provider Business Mailing Address
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Address Line | 10455 N CENTRAL EXPY, #109 PMB 125
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City | DALLAS
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State | TX
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Zip | 75231-2215
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Country | US
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Telephone | 469-518-7853
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Fax | 469-232-9917
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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 | 246ZC0007X
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Taxonomy Name | Surgical Assistant
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License Number | 199074
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License Number State | TX
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