Individual
DR. EDIC STEPHANIAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
601 CLARA BARTON BLVD STE 350, GARLAND, TX 75042-5747
(972) 426-9900
(972) 426-9899
Mailing address
601 CLARA BARTON BLVD STE 350, GARLAND, TX 75042-5747
(972) 426-9900
(972) 426-9899
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
J6256
TX
2086S0129X
Vascular Surgery Physician
Primary
J6256
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
123939402
—
TX
Enumeration date
05/11/2006
Last updated
06/30/2021
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