1073521381 NPI number — DR. RALPH G STEIN D.O.

Table of content: DR. RALPH G STEIN D.O. (NPI 1073521381)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1073521381 NPI number — DR. RALPH G STEIN D.O.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
STEIN
Provider First Name:
RALPH
Provider Middle Name:
G
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
D.O.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1073521381
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/09/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
P O BOX 1108
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LANCASTER
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75146
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
254-694-5092
Provider Business Mailing Address Fax Number:
254-694-7039

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
508 WOODSTREAM PLACE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MESQUITE
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
75149
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
254-694-5092
Provider Business Practice Location Address Fax Number:
254-694-7039
Provider Enumeration Date:
08/03/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207LP2900X , with the licence number:  G4407 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)