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Individual

DR. STEPHEN W LACEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
505 S NOLEN DR, SOUTHLAKE, TX 76092-9167
(817) 424-1525
(817) 424-3491
Mailing address
PO BOX 35629, DALLAS, TX 75235-0629
(214) 424-2213
(214) 231-2159

Taxonomy

Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
G7543
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
125114201
TX
01
82W275
BCBS
TX
Enumeration date
12/21/2005
Last updated
05/23/2013
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