MEDICARE: STEPHANIE BSAIBES PA-C

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	363A00000X	Physician Assistant	PA14082	TX

General Provider Information

NPI Number	:	1548852577
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEPHANIE BSAIBES PA-C

Provider Business Mailing Address
First Line	:	9212 SLATE CREEK TRL
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78717-2934
Country	:	US
Telephone Number	:	512-964-2855
Fax Number	:

Provider Business Practice Location Address
First Line	:	6550 FANNIN ST STE 2435
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77030-2767
Country	:	US
Telephone Number	:	713-790-3140
Fax Number	:

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

Provider Enumeration Date	:	02/10/2021
Last Update Date	:	02/10/2021

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Directions to “ STEPHANIE BSAIBES PA-C” Practice Location

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