Individual
MICHEL KHAMIS STEPHAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2540 NTH GALLOWAY AVENUE, 101, MESQUITE, TX 75150
(972) 226-0405
(972) 270-4959
Mailing address
2540 NTH GALLOWAY AVENUE, 101, MESQUITE, TX 75150
(972) 226-0405
(972) 270-4959
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
F8687
TX
2086S0129X
Vascular Surgery Physician
F8687
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
123330601
—
TX
Enumeration date
03/20/2006
Last updated
10/03/2013
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