MEDICARE: STEPHANIE MICHELE KUFERT PA

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	363AM0700X	Medical Physician Assistant		TX

General Provider Information

NPI Number	:	1154591832
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEPHANIE MICHELE KUFERT PA

Provider Business Mailing Address
First Line	:	4801 S BUCKNER BLVD
Second Line	:	SUITE 200
City	:	DALLAS
State	:	TX
Zip	:	75227-2373
Country	:	US
Telephone Number	:	214-381-5500
Fax Number	:	214-381-5510

Provider Business Practice Location Address
First Line	:	4801 S BUCKNER BLVD
Second Line	:	SUITE 200
City	:	DALLAS
State	:	TX
Zip	:	75227-2373
Country	:	US
Telephone Number	:	214-381-5500
Fax Number	:	214-381-5510

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

Provider Enumeration Date	:	03/10/2008
Last Update Date	:	01/27/2009

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