Provider Demographics
NPI:1528051034
Name:OZANNE, STEPHEN (MD)
Entity type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:
Last Name:OZANNE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 543066
Mailing Address - Street 2:
Mailing Address - City:GRAND PRAIRIE
Mailing Address - State:TX
Mailing Address - Zip Code:75054-3066
Mailing Address - Country:US
Mailing Address - Phone:972-299-6966
Mailing Address - Fax:972-299-9100
Practice Address - Street 1:3450 W WHEATLAND RD
Practice Address - Street 2:SUITE 330
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75237-3470
Practice Address - Country:US
Practice Address - Phone:972-299-6966
Practice Address - Fax:972-299-9100
Is Sole Proprietor?:No
Enumeration Date:2005-08-30
Last Update Date:2016-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG8637207XS0117X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the Spine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0026ENOtherBLUE CROSS/SHIELD
TX122086504Medicaid
TX200038682OtherRAILROAD MEDICARE
TXB25336Medicare UPIN
TX200038682OtherRAILROAD MEDICARE