Individual
STEPHEN ANDRE CHILDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
211 E 7TH ST STE 620, AUSTIN, TX 78701-3218
(800) 370-3651
Mailing address
110 DEATS RD APT 67, DICKINSON, TX 77539-4264
(678) 612-5664
(888) 613-1157
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
226436
AZ
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
AP139818
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AP139818
STATE LICENSE
TX
Enumeration date
12/17/2018
Last updated
10/14/2019
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