Individual
GARY BEN STEPHENS
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1901 N MACARTHUR BLVD, IRVING, TX 75061-2220
(972) 579-8100
Mailing address
11815 FORESTGATE DR, DALLAS, TX 75243-5414
(972) 234-6600
(972) 234-6575
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
32005
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AMERIGROUP-10031217
GARY STEPHENS, CRNA
TX
01
—
BLUE CROSS-82822U
GARY STEPHENS, CRNA
TX
Enumeration date
05/27/2006
Last updated
07/09/2007
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