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General NPI Number Information
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NPI Number | 1699814616
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Entity Type | Individual
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Provider Name | STEPHEN STIMSON MD
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Gender | Male
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Dates
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Enumeration Date | 02/06/2007
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Last Update Date | 01/30/2013
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Provider Practice Location Address
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Address Line | 601 W HWY 6 STE 105
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City | WACO
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State | TX
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Zip | 76710-5592
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Country | US
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Telephone | 254-741-6113
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Fax |
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Provider Business Mailing Address
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Address Line | 27 TIMBER RIDGE TRL
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City | LORENA
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State | TX
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Zip | 76655-3035
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Country | US
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Telephone | 254-652-5250
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Fax |
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | 74-2600261
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License Number State | TX
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