Stephenson, Gerald Robert
Stephenson, Gerald Robert is an individual health care provider with primary practice located at 1500 S Main St Ste 303 , Fort Worth TX 76104-4917. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Surgical Oncology, Allopathic & Osteopathic Physicians / Surgery. Allopathic & Osteopathic Physicians / Surgery is his primary health care specialty. Stephenson, Gerald Robert can be contacted via phone (817) 702-1172.Contact Information
Primary practice address
1500 S Main St Ste 303
Fort Worth TX 76104-4917
Phone: (817) 702-1172
Fax: (817) 702-1605
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Surgical Oncology | 2086X0206X | L9503 | Texas |
| Allopathic & Osteopathic Physicians / Surgery | 208600000X | L9503 | Texas |
Profile Details
| NPI number | 1598781122 |
|---|---|
| LBN Legal business name | Stephenson, Gerald Robert |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 15th, 2006 |
| Last updated | Mar 10th, 2023 - about 3 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1598781122 | NPPES |
| Texas | MEDICAID | 168027402 | |
| Texas | Other | P00254219 |
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