Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223X0400X | Orthodontists | 9125 | TX |
NPI | 1073622809 |
---|---|
Provider Name | Dr. Harold Chapman Stevenson III |
First Address | Katy, TX 77494-6405 |
Second Address | Katy, TX 77494-6405 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/08/2006 |
Last Update Date | 08/07/2007 |