Provider Demographics
NPI:1316662042
Name:HUBERT, STEPHANIE SHANAE
Entity type:Individual
Prefix:MRS
First Name:STEPHANIE
Middle Name:SHANAE
Last Name:HUBERT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12730 KIEV HILLS LN
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77047-4000
Mailing Address - Country:US
Mailing Address - Phone:713-440-8520
Mailing Address - Fax:
Practice Address - Street 1:12730 KIEV HILLS LN
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77047-4000
Practice Address - Country:US
Practice Address - Phone:713-440-8520
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-05
Last Update Date:2022-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program