Stephenson, Gerald Robert

Stephenson, Gerald Robert is an individual health care provider with primary practice located at 1500 S Main St Ste 303 , Fort Worth TX 76104-4917. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Surgical Oncology, Allopathic & Osteopathic Physicians / Surgery. Allopathic & Osteopathic Physicians / Surgery is his primary health care specialty. Stephenson, Gerald Robert can be contacted via phone (817) 702-1172.

Contact Information

Primary practice address
1500 S Main St Ste 303 Fort Worth TX 76104-4917
Phone: (817) 702-1172
Fax: (817) 702-1605
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgical Oncology 2086X0206X L9503 Texas
Allopathic & Osteopathic Physicians / Surgery 208600000X L9503 Texas

Profile Details

NPI number 1598781122
LBN Legal business name Stephenson, Gerald Robert
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 15th, 2006
Last updated Mar 10th, 2023 - about 2 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 1598781122 NPPES
Texas MEDICAID 168027402
Texas Other P00254219

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