MEDICARE: DR. STEPHEN ALTER TEW M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0800X	Psychiatry Physician	E4716	TX

General Provider Information

NPI Number	:	1114917713
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. STEPHEN ALTER TEW M.D.

Provider Business Mailing Address
First Line	:	3400 BISSONNET ST
Second Line	:	SUITE 206
City	:	HOUSTON
State	:	TX
Zip	:	77005-2100
Country	:	US
Telephone Number	:	713-661-0404
Fax Number	:

Provider Business Practice Location Address
First Line	:	3400 BISSONNET ST
Second Line	:	SUITE 206
City	:	HOUSTON
State	:	TX
Zip	:	77005-2155
Country	:	US
Telephone Number	:	713-661-0404
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/25/2005
Last Update Date	:	07/08/2007

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