Provider Demographics
NPI:1528346822
Name:STEPHENS, CLAUDE PATRICK (PTA)
Entity type:Individual
Prefix:MR
First Name:CLAUDE
Middle Name:PATRICK
Last Name:STEPHENS
Suffix:
Gender:M
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1810 23RD ST
Mailing Address - Street 2:
Mailing Address - City:GALVESTON
Mailing Address - State:TX
Mailing Address - Zip Code:77550-7904
Mailing Address - Country:US
Mailing Address - Phone:409-763-7025
Mailing Address - Fax:409-763-8648
Practice Address - Street 1:1810 23RD ST
Practice Address - Street 2:
Practice Address - City:GALVESTON
Practice Address - State:TX
Practice Address - Zip Code:77550-7904
Practice Address - Country:US
Practice Address - Phone:409-763-7025
Practice Address - Fax:409-763-8648
Is Sole Proprietor?:No
Enumeration Date:2011-08-03
Last Update Date:2011-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2001319225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant