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NPI Code Detail

MEDICARE: STEPHENS FAMILY HEALTHCARE INC

MEDICARE: STEPHENS FAMILY HEALTHCARE INC
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
1261QP2300XPrimary Care Clinic/Center

General Provider Information

NPI Number : 1215404942
Entity Type Code : Organization
Provider Name (Legal Business Name) : STEPHENS FAMILY HEALTHCARE INC
Provider Business Mailing Address
First Line : 2912A MANGUM RD
Second Line :
City : HOUSTON
State : TX
Zip : 77092-7408
Country : US
Telephone Number : 832-740-4107
Fax Number : 832-530-4905
Provider Business Practice Location Address
First Line : 2912A MANGUM RD
Second Line :
City : HOUSTON
State : TX
Zip : 77092-7408
Country : US
Telephone Number : 832-740-4107
Fax Number : 832-530-4905
Authorized Official
Title or Position : ADMINISTRATOR
Name : ALEXANDER-P IKE STEPHENS
Credential : FNP-BC
Telephone Number : 832-740-4107
Provider Enumeration Date : 10/31/2018
Last Update Date : 12/13/2018

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Directions to “STEPHENS FAMILY HEALTHCARE INC ” Practice Location

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