Individual
DR. ALBERT M STEPHEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
800 E DAWSON ST, TYLER, TX 75701-2036
(903) 780-2364
(903) 565-0128
Mailing address
PO BOX 130907, TYLER, TX 75713-0907
(903) 780-2364
(903) 565-0128
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
K1937
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
124564905
—
TX
01
—
8X8900
BCBS
TX
01
—
P00403736
RAILROAD MEDICARE
TX
Enumeration date
02/22/2006
Last updated
12/15/2021
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