Basic Information
| Provider Information | |||||||||
| NPI: | 1205127305 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BOONE | ||||||||
| FirstName: | STEPHEN | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1504 TAUB LOOP | ||||||||
| Address2: | DEPARTMENT OF EMERGENCY MEDICINE | ||||||||
| City: | HOUSTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 770301608 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7138732626 | ||||||||
| FaxNumber: | 7138736604 | ||||||||
| Practice Location | |||||||||
| Address1: | 1504 TAUB LOOP | ||||||||
| Address2: | DEPARTMENT OF EMERGENCY MEDICINE | ||||||||
| City: | HOUSTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 770301608 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7138732626 | ||||||||
| FaxNumber: | 7138736604 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/22/2011 | ||||||||
| LastUpdateDate: | 06/24/2016 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 207R00000X | C1-0010261 | DE | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207P00000X | C1-0010261 | DE | N | Allopathic & Osteopathic Physicians | Emergency Medicine | 207P00000X | Q7153 | TX | Y | Allopathic & Osteopathic Physicians | Emergency Medicine | 207R00000X | Q7153 | TX | N | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.