Organization
STEPHEN S IM MDPA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHEN S IM MD (OWNER)
(210) 655-6400
Entity
Organization
Contact information
Practice address
12709 TOEPPERWEIN RD, SUITE 201, LIVE OAK, TX 78233-3258
(210) 655-6400
(210) 655-6404
Mailing address
12709 TOEPPERWEIN RD, SUITE 201, LIVE OAK, TX 78233-3258
(210) 655-6400
(210) 655-6404
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
—
—
207RP1001X
Pulmonary Disease Physician
Primary
—
—
Other
Enumeration date
10/11/2008
Last updated
12/17/2008
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