Basic Information
| Provider Information | |||||||||
| NPI: | 1083845036 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ALDRET | ||||||||
| FirstName: | STEPHANIE | ||||||||
| MiddleName: | N | ||||||||
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| Credential: | D.O. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 18444 N 25TH AVE | ||||||||
| Address2: | 310 | ||||||||
| City: | PHOENIX | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 850231261 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6234743696 | ||||||||
| FaxNumber: | 6235445531 | ||||||||
| Practice Location | |||||||||
| Address1: | 3521 HIGHWAY 190 | ||||||||
| Address2: | SUITE C | ||||||||
| City: | EUNICE | ||||||||
| State: | LA | ||||||||
| PostalCode: | 705355135 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3372358007 | ||||||||
| FaxNumber: | 8552705479 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/06/2009 | ||||||||
| LastUpdateDate: | 11/29/2016 | ||||||||
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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 | 207Q00000X | 102202830 | VA | N | Allopathic & Osteopathic Physicians | Family Medicine | 207Q00000X | 4734 | OK | N | Allopathic & Osteopathic Physicians | Family Medicine | 207Q00000X | 2548 | WV | N | Allopathic & Osteopathic Physicians | Family Medicine | 207QS0010X | DO.000291 | LA | Y | Allopathic & Osteopathic Physicians | Family Medicine | Sports Medicine |
No ID Information.