Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QS0010X | Family Doctor - Sports Medicine | P4385 | TX |
NPI | 1164743621 |
---|---|
Provider Name | Lindsay Page Stephens |
First Address | San Antonio, TX 78248-2633 |
Second Address | San Antonio, TX 78248-1683 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/06/2010 |
Last Update Date | 12/02/2015 |