Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | 1673 | TX |
Y | 222Z00000X | Podiatrist | 1673 | TX |
NPI | 1043214919 |
---|---|
Provider Name | Steven J Stanton |
First Address | Cypress, TX 77433-7886 |
Second Address | Cypress, TX 77433-7886 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/06/2005 |
Last Update Date | 20/12/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
168419301 | (05) | TX |
8AJ844 | BCBS TX (01) | TX |
P00186878 | RAILROAD MEDICARE (01) | TX |
U99618 | (02) | TX |