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NPI Code Detail

MEDICARE: STEVIE MCGILL RBT

MEDICARE: STEVIE MCGILL RBT
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
1247200000XOther TechnicianRBT-17-33879TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1RBT-17-33879OTHERTXBACB

General Provider Information

NPI Number : 1730644139
Entity Type Code : Individual
Provider Name (Legal Business Name) : STEVIE MCGILL RBT
Provider Business Mailing Address
First Line : 3100 PREMIER DR STE 234
Second Line :
City : IRVING
State : TX
Zip : 75063-2693
Country : US
Telephone Number : 972-756-1222
Fax Number :
Provider Business Practice Location Address
First Line : 3100 PREMIER DR STE 234
Second Line :
City : IRVING
State : TX
Zip : 75063-2693
Country : US
Telephone Number : 972-756-1222
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/10/2019
Last Update Date : 02/10/2019

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Directions to “ STEVIE MCGILL RBT” Practice Location

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