Basic Information
| Provider Information | |||||||||
| NPI: | 1013113034 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | FREEMAN | ||||||||
| FirstName: | STEPHANIE | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1133 JOHN FREEMAN BLVD | ||||||||
| Address2: | JJL 4TH FLOOR | ||||||||
| City: | HOUSTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 770302809 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7135007878 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1133 JOHN FREEMAN BLVD | ||||||||
| Address2: | JJL 4TH FLOOR | ||||||||
| City: | HOUSTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 770302809 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7135007878 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/26/2007 | ||||||||
| LastUpdateDate: | 07/09/2009 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207PP0204X | N2509 | TX | N | Allopathic & Osteopathic Physicians | Emergency Medicine | Pediatric Emergency Medicine | 208000000X | N2509 | TX | Y | Allopathic & Osteopathic Physicians | Pediatrics |
No ID Information.