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General NPI Number Information
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NPI Number | 1689780116
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Entity Type | Organization
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Legal Business Name | ALPHONSA STEPHEN M.D., P.C.
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Dates
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Enumeration Date | 08/21/2006
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Last Update Date | 03/14/2013
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Provider Practice Location Address
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Address Line | 5775 S FORT APACHE RD STE 110
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City | LAS VEGAS
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State | NV
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Zip | 89148-5627
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Country | US
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Telephone | 702-450-0003
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Fax | 702-795-3306
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Provider Business Mailing Address
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Address Line | 5775 S FORT APACHE RD STE 110
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City | LAS VEGAS
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State | NV
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Zip | 89148-5627
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Country | US
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Telephone | 702-450-0003
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Fax | 702-795-3306
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Authorized Official
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Title or Position | PROVIDER
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Name | ALPHONSA STEPHEN
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Credential |
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Telephone | 702-450-0003
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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 | 9479
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License Number State | NV
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