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General NPI Number Information
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NPI Number | 1831629443
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Entity Type | Individual
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Provider Name | STEPHANIE MINH-THU TAN DO
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Gender | Female
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Dates
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Enumeration Date | 06/15/2017
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Last Update Date | 09/24/2025
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Provider Practice Location Address
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Address Line | 22420 IH 35 STE 203
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City | KYLE
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State | TX
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Zip | 78640-2656
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Country | US
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Telephone | 512-272-4636
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Fax | 512-406-7327
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Provider Business Mailing Address
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Address Line | 6210 E HWY 290 STE 240
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City | AUSTIN
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State | TX
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Zip | 78723-1144
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Country | US
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Telephone | 512-338-3826
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Fax | 512-406-6216
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | S6003
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License Number State | TX
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