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Individual
DR. STEPHEN WESLEY LINE
Active
Individual
DR. STEPHEN WESLEY LINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
BP10063117
TX
207Q00000X
Family Medicine Physician
Primary
S6243
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2J5586
MEDICARE
TX
Enumeration date
04/05/2018
Last updated
06/04/2024
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