Individual
DR. STEPHEN MELVYN LOBO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
815 PENNSYLVANIA AVENUE, FORT WORTH, TX 76104-2224
(817) 321-0312
(817) 317-7033
Mailing address
815 PENNSYLVANIA AVE, FORT WORTH, TX 76104-2224
(817) 321-0404
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
M7376
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
191564701
—
TX
01
—
M7376
TEXAS PHYSICIANS PERMIT
TX
Enumeration date
04/11/2007
Last updated
02/03/2021
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