Provider Demographics
NPI:1386697605
Name:LORRAINE STEHN,DOPA
Entity type:Organization
Organization Name:LORRAINE STEHN,DOPA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LORRAINE
Authorized Official - Middle Name:S
Authorized Official - Last Name:STEHN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:361-758-2799
Mailing Address - Street 1:1731 W WHEELER AVE
Mailing Address - Street 2:
Mailing Address - City:ARANSAS PASS
Mailing Address - State:TX
Mailing Address - Zip Code:78336-4536
Mailing Address - Country:US
Mailing Address - Phone:361-758-2799
Mailing Address - Fax:361-758-2707
Practice Address - Street 1:1731 W WHEELER AVE
Practice Address - Street 2:
Practice Address - City:ARANSAS PASS
Practice Address - State:TX
Practice Address - Zip Code:78336-4536
Practice Address - Country:US
Practice Address - Phone:361-758-2799
Practice Address - Fax:361-758-2707
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-18
Last Update Date:2011-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF7932207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX133365008Medicaid
TXA67699Medicare UPIN
TXTXB102377Medicare PIN
TXTXB102376Medicare PIN