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:
Map and Directions

Health care specialties

SpecialtyCodeLicense #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 13 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1821086729 NPPES
Texas Other 8CR485 BCBS
Texas MEDICAID 168108203 BCBS

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