Kubacak, Stephanie Alexandra
Kubacak, Stephanie Alexandra is an individual health care provider with primary practice located at 8050 E Highway 191 Ste 200 , Odessa TX 79765-8607. She recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as her primary health care specialty. Kubacak, Stephanie Alexandra can be contacted via phone (432) 337-5411.Contact Information
Primary practice address
8050 E Highway 191 Ste 200
Odessa TX 79765-8607
Phone: (432) 337-5411
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | L8779 | Texas |
Profile Details
| NPI number | 1821086729 |
|---|---|
| LBN Legal business name | Kubacak, Stephanie Alexandra |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 13th, 2005 |
| Last updated | Aug 8th, 2011 - about 14 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1821086729 | NPPES |
| Texas | Other | 8CR485 | BCBS |
| Texas | MEDICAID | 168108203 | BCBS |
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