Basic Information
| Provider Information | |||||||||
| NPI: | 1356401343 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | NESBIT | ||||||||
| FirstName: | STEPHEN | ||||||||
| MiddleName: | WARNER | ||||||||
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| NameSuffix: | |||||||||
| Credential: | DO | ||||||||
| OtherOrganizationName: | |||||||||
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| Mailing Information | |||||||||
| Address1: | 1917 W GRAY ST | ||||||||
| Address2: | |||||||||
| City: | HOUSTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 770194801 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8322600650 | ||||||||
| FaxNumber: | 3168583458 | ||||||||
| Practice Location | |||||||||
| Address1: | 1917 W GRAY ST | ||||||||
| Address2: | |||||||||
| City: | HOUSTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 770194801 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8322600650 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/11/2006 | ||||||||
| LastUpdateDate: | 10/12/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 10/12/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 05-37032 | KS | N | Allopathic & Osteopathic Physicians | Family Medicine | 207Q00000X | G1491 | TX | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.