Individual
MR. CHARLES BELL STEPHENSON II
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.T.
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1061596
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1061596
PHYSICAL THERAPY LICENSE
TX
01
—
5163185
AETNA PPO
TX
01
—
82672T
BLUE CROSS, BLUE SHIELD
TX
01
—
873080
AETNA HMO
TX
Enumeration date
03/29/2007
Last updated
07/08/2007
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
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