MEDICARE: J. ROBERT STEPHEN, D.D.S., P.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	261QD0000X	Dental Clinic/Center	15321	TX

General Provider Information

NPI Number	:	1780708941
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	J. ROBERT STEPHEN, D.D.S., P.C.

Provider Business Mailing Address
First Line	:	13231 CHAMPION FOREST DRIVE
Second Line	:	SUITE 301
City	:	HOUSTON
State	:	TX
Zip	:	77069
Country	:	US
Telephone Number	:	281-893-4848
Fax Number	:

Provider Business Practice Location Address
First Line	:	13231 CHAMPION FOREST DRIVE
Second Line	:	SUITE 301
City	:	HOUSTON
State	:	TX
Zip	:	77069-2648
Country	:	US
Telephone Number	:	281-893-4848
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. JAMES ROBERT STEPHEN
Credential	:	D.D.S.
Telephone Number	:	281-893-4848

Provider Enumeration Date	:	03/16/2007
Last Update Date	:	08/22/2020

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