Individual
DR. STACY RANDOLPH STEPHENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
6200 W PARKER RD, MOB 1 SUITE 502, PLANO, TX 75093-7939
(972) 312-1309
(972) 312-1662
Mailing address
5936 GLADESIDE CT, DALLAS, TX 75248-2111
(972) 931-6124
(972) 931-6164
Taxonomy
Speciality
Code
Description
License number
State
207VG0400X
Gynecology Physician
Primary
D5324
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
824472
BLUE CROSS BLUE SHIELD
TX
Enumeration date
07/17/2006
Last updated
12/13/2007
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