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Individual
DR. EDIC STEPHANIAN
Active
Individual
DR. EDIC STEPHANIAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
J6256
TX
2086S0129X
Vascular Surgery Physician
Primary
J6256
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
123939402
—
TX
Enumeration date
05/11/2006
Last updated
06/30/2021
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