Basic Information
| Provider Information | |||||||||
| NPI: | 1164743621 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | STEPHENS | ||||||||
| FirstName: | LINDSAY | ||||||||
| MiddleName: | PAGE | ||||||||
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| Credential: | DO | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1511 BLUFF FRST | ||||||||
| Address2: | |||||||||
| City: | SAN ANTONIO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 782482633 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2103633311 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 16403 HUEBNER RD | ||||||||
| Address2: | SUITE 100 | ||||||||
| City: | SAN ANTONIO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 782481683 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2104934959 | ||||||||
| FaxNumber: | 2104934355 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/18/2010 | ||||||||
| LastUpdateDate: | 02/12/2015 | ||||||||
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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 | 207QS0010X | P4385 | TX | Y | Allopathic & Osteopathic Physicians | Family Medicine | Sports Medicine |
No ID Information.