Individual
STEPHANIE BAUSSAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
6550 FANNIN ST STE 749, HOUSTON, TX 77030-2738
(713) 441-7465
Mailing address
6550 FANNIN ST STE 749, HOUSTON, TX 77030-2738
(713) 441-7465
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
R7660
TX
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/23/2011
Last updated
08/05/2020
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