Individual
STEPHAN ALLAN SHIVVERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5323 HARRY HINES BLVD, DALLAS, TX 75390-7208
(214) 645-0624
(214) 645-0078
Mailing address
PO BOX 845347, DALLAS, TX 75284-5347
(214) 645-0624
(214) 645-0078
Taxonomy
Speciality
Code
Description
License number
State
207SG0201X
Clinical Genetics (M.D.) Physician
K1676
TX
207V00000X
Obstetrics & Gynecology Physician
K1676
TX
207VM0101X
Maternal & Fetal Medicine Physician
Primary
K1676
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
045409202
—
TX
05
—
045409204
—
TX
Enumeration date
04/28/2006
Last updated
04/24/2026
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