Provider Demographics
NPI:1417927328
Name:VINSON, STEPHEN L (DO)
Entity type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:L
Last Name:VINSON
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13918 FM455
Mailing Address - Street 2:
Mailing Address - City:FORESTBURG
Mailing Address - State:TX
Mailing Address - Zip Code:76239
Mailing Address - Country:US
Mailing Address - Phone:940-964-2230
Mailing Address - Fax:
Practice Address - Street 1:FM51 SOUTH
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:TX
Practice Address - Zip Code:76234
Practice Address - Country:US
Practice Address - Phone:940-625-1249
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF7266207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX84788FOtherBCBS
TX930069823OtherMEDICARE RAILROAD
TX135484707Medicaid
TX135484705Medicaid
TX88496KOtherBCBS
TX930045366OtherMEDICARE RAILROAD
TX135484705Medicaid
TX88496KOtherBCBS
TXD79676Medicare UPIN