MEDICARE: DR. STEPHEN EDWARD MAHONEY 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	174400000X	Specialist	H6399	TX

General Provider Information

NPI Number	:	1295743490
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. STEPHEN EDWARD MAHONEY M.D.

Provider Business Mailing Address
First Line	:	2925 BRIARPARK DR STE 150
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77042-3732
Country	:	US
Telephone Number	:	281-558-3376
Fax Number	:	281-558-0544

Provider Business Practice Location Address
First Line	:	2925 BRIARPARK DR STE 250
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77042-3720
Country	:	US
Telephone Number	:	281-558-3376
Fax Number	:	281-558-0544

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

Provider Enumeration Date	:	08/03/2006
Last Update Date	:	12/16/2022

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