Basic Information
Provider Information
NPI: 1801385018
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: STRYKER
FirstName: STEPHANIE
MiddleName: LEE
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
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OtherCredential:  
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Mailing Information
Address1: 211 YOSEMITE DR
Address2:  
City: SAN ANTONIO
State: TX
PostalCode: 782321325
CountryCode: US
TelephoneNumber: 2545414002
FaxNumber:  
Practice Location
Address1: 919 E 32ND ST
Address2:  
City: AUSTIN
State: TX
PostalCode: 787052703
CountryCode: US
TelephoneNumber: 5125447111
FaxNumber:  
Other Information
ProviderEnumerationDate: 05/02/2018
LastUpdateDate: 01/09/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
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AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
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AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
367H00000X TXY Physician Assistants & Advanced Practice Nursing ProvidersAnesthesiologist Assistant 

No ID Information.


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