Provider Demographics
NPI:1528148996
Name:NEVINS, STEPHEN A (DPM)
Entity type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:A
Last Name:NEVINS
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:DR
Other - First Name:STEPHEN
Other - Middle Name:A
Other - Last Name:NEVINS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DPM
Mailing Address - Street 1:15919 PARKSLEY DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77059-4630
Mailing Address - Country:US
Mailing Address - Phone:281-488-4132
Mailing Address - Fax:
Practice Address - Street 1:2002 HOLCOMBE BLVD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-4211
Practice Address - Country:US
Practice Address - Phone:713-791-1414
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1388213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXU70144Medicare UPIN