Provider Demographics
NPI:1588339576
Name:ST STEPHENS HEALTHCARE SOLUTIONS PLLC
Entity type:Organization
Organization Name:ST STEPHENS HEALTHCARE SOLUTIONS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CHIDI
Authorized Official - Middle Name:
Authorized Official - Last Name:ANI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:316-312-5850
Mailing Address - Street 1:23614 FAIRPORT HARBOR LANE
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77407
Mailing Address - Country:US
Mailing Address - Phone:316-312-5850
Mailing Address - Fax:
Practice Address - Street 1:23614 FAIRPORT HARBOR LANE
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77407
Practice Address - Country:US
Practice Address - Phone:316-312-5850
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-11
Last Update Date:2021-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain MedicineGroup - Multi-Specialty
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Multi-Specialty