1912073883 NPI number — IRVING & STEPHENSON DDS, RLLP

Table of content: (NPI 1912073883)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1912073883 NPI number — IRVING & STEPHENSON DDS, RLLP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
IRVING & STEPHENSON DDS, RLLP
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
IRVING, STEPHENSON, & CURTIS DDS, RLLP
Provider Other Organization Name Type Code:
4
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:
1912073883
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/27/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
747 NEW HWY 287 N.
Provider Second Line Business Mailing Address:
SUITE A
Provider Business Mailing Address City Name:
MANSFIELD
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
76063-2619
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
817-473-0244
Provider Business Mailing Address Fax Number:
817-473-9878

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
747 NEW HWY 287 N.
Provider Second Line Business Practice Location Address:
SUITE A
Provider Business Practice Location Address City Name:
MANSFIELD
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
76063-2619
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
817-473-0244
Provider Business Practice Location Address Fax Number:
817-473-9878
Provider Enumeration Date:
11/24/2006

Additional Information

Authorized Official

Authorized Official Last Name:
STEPHENSON
Authorized Official First Name:
LEWIS
Authorized Official Middle Name:
H.
Authorized Official Title or Position:
PARTNER
Authorized Official Telephone Number:
817-473-0244

Provider Taxonomy Codes

  • Taxonomy code: 122300000X , with the licence number:  13096 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 122300000X , with the licence number: 15096 , registered in the state of OK ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 122300000X , with the licence number: 22700 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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





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