| Provider / Organization | NPI | Date Certified |
|---|---|---|
| JACOB T STEPHENSON | 1265411979 | 2024-01-07 |
Jacob T Stephenson is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1265411979. Registration indicates Jacob T Stephenson is a provider of services with a specialization in Allopathic & Osteopathic Physicians, Surgery (Surgery, ) (Specialist Network, ) (Surgery, Allopathic & Osteopathic Physicians) (Allopathic & Osteopathic Physicians, Surgery) (Surgery: Pediatric Surgery, ) (Specialist Network, ) (Surgery Pediatric Surgery, Allopathic & Osteopathic Physicians) (Surgery, ) (Allopathic & Osteopathic Physicians, Surgery) (Surgery: Pediatric Surgery, ) (Specialist Network, ) (Surgery Pediatric Surgery, Allopathic & Osteopathic Physicians) (Surgery, )
| Registration | PART-B:Y DME:Y HHA:Y PMD:Y |
| Entity Type | Individual |
| Provider Name | Jacob T Stephenson MD |
| Practice Office Address | 1102 BATES AVE # FC1440 HOUSTON, TX US |
| Practice Office Telephone | 8328283660 |
| Mailing Address | 1102 BATES AVE # FC1440 HOUSTON, TX 770302698 US |
| Business Telephone | 8328283660 |
| Address | City / State | Phone / Fax |
|---|---|---|
| Building 922, 48th MDG RAF Lakenheath | APO, AE 094640030 | 9167343510 |
| Code | Practice | License No State |
|---|---|---|
| 208600000X | Allopathic & Osteopathic Physicians Surgery Surgery Specialist Network Surgery Allopathic & Osteopathic Physicians | U5819
TX |
| 2086S0120X | Allopathic & Osteopathic Physicians Surgery Surgery: Pediatric Surgery Specialist Network Surgery Pediatric Surgery Allopathic & Osteopathic Physicians Surgery | 92264
CA |
| 2086S0120X PRIMARY | Allopathic & Osteopathic Physicians Surgery Surgery: Pediatric Surgery Specialist Network Surgery Pediatric Surgery Allopathic & Osteopathic Physicians Surgery | U5819
TX |