Provider Demographics
NPI:1063540409
Name:CARPENTER, STEPHEN KENT (BCHIS)
Entity type:Individual
Prefix:
First Name:STEPHEN
Middle Name:KENT
Last Name:CARPENTER
Suffix:
Gender:M
Credentials:BCHIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8900 VISCOUNT BLVD
Mailing Address - Street 2:A-M
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79925-5897
Mailing Address - Country:US
Mailing Address - Phone:915-598-7777
Mailing Address - Fax:915-598-0341
Practice Address - Street 1:8900 VISCOUNT BLVD
Practice Address - Street 2:A-M
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79925-5897
Practice Address - Country:US
Practice Address - Phone:915-598-7777
Practice Address - Fax:915-598-0341
Is Sole Proprietor?:No
Enumeration Date:2007-02-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX50336237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX516504OtherBLUE CROSS BLUE SHIELD