Provider Demographics
NPI:1154591832
Name:KUFERT, STEPHANIE MICHELE (PA)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:MICHELE
Last Name:KUFERT
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4801 S BUCKNER BLVD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75227-2373
Mailing Address - Country:US
Mailing Address - Phone:214-381-5500
Mailing Address - Fax:214-381-5510
Practice Address - Street 1:4801 S BUCKNER BLVD
Practice Address - Street 2:SUITE 200
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75227-2373
Practice Address - Country:US
Practice Address - Phone:214-381-5500
Practice Address - Fax:214-381-5510
Is Sole Proprietor?:No
Enumeration Date:2008-03-10
Last Update Date:2009-01-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical