Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NN0400X | Neurology | 7083 | TX |
NPI | 1124194170 |
---|---|
Provider Name | Dr. Stephen Ward |
First Address | Coppell, TX 75019-5786 |
Second Address | Coppell, TX 75019-5786 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/11/2006 |
Last Update Date | 08/07/2007 |