Individual
STEPHEN WALTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
801 CLARKSVILLE ST STE C, PARIS, TX 75460-0220
(903) 784-7210
Mailing address
PO BOX 1307, PARIS, TX 75461-1307
(903) 784-7210
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
K4827
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
153785403
—
TX
05
—
200039610A
—
OK
01
—
BCBS
8R9450
TX
01
—
HMO BLUE
8R9450
TX
Enumeration date
06/21/2006
Last updated
08/08/2023
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