1457574576 NPI number — DR. STEPHANIE HELM FLEMING O.D.

Table of content: DR. STEPHANIE HELM FLEMING O.D. (NPI 1457574576)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1457574576 NPI number — DR. STEPHANIE HELM FLEMING O.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
FLEMING
Provider First Name:
STEPHANIE
Provider Middle Name:
HELM
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
O.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
HELM
Provider Other First Name:
STEPHANIE
Provider Other Middle Name:
SUZANNE
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
OD
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1457574576
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/14/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5442 LA SIERRA DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DALLAS
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75231-4108
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
214-828-9900
Provider Business Mailing Address Fax Number:
214-828-9900

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5442 LA SIERRA DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DALLAS
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
75231-4108
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
214-828-9900
Provider Business Practice Location Address Fax Number:
214-828-9900
Provider Enumeration Date:
04/10/2007

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: 152WL0500X , with the licence number:  5703TG , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 152WL0500X , with the licence number: 5703T , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 152W00000X , with the licence number: 5703TG , 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)

  • Identifier: 038410901 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".