# ELIAS STEPHAN

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1811981996
- **Gender:** Man
- **Credential:** MD

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RE0101X | Endocrinology, Diabetes & Metabolism Physician | L4734 | TX | Yes |

## Other

- **Enumeration date:** 09/06/2005
- **Last updated:** 04/24/2023

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 05086764 | ECFMG NUMBER | TX |
| 01 | — | 7362515 | AETNA PROVIDER ID NUMBER | TX |
| 01 | — | 8V4810 | BCBS PIN | TX |