| Alan D Stephenson, Phd | |
|
326 S Ravinia Dr Dallas TX 75211-5182 | |
| (214) 549-5442 | |
| (214) 339-2279 |
| Full Name | Alan D Stephenson, Phd |
|---|---|
| Speciality | Psychologist |
| Location | 326 S Ravinia Dr, Dallas, Texas |
| Authorized Official Name and Position | Alan D. Stephenson (PRESIDENT) |
| Authorized Official Contact | 9728035294 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Alan D Stephenson, Phd 326 S Ravinia Dr Dallas TX 75211-5182 Ph: (214) 549-5442 | Alan D Stephenson, Phd 326 S Ravinia Dr Dallas TX 75211-5182 Ph: (214) 549-5442 |
| NPI Number | 1710182134 |
|---|---|
| Provider Enumeration Date | 06/16/2007 |
| Last Update Date | 02/07/2020 |
| Certification Date | 02/07/2020 |
| Medicare PECOS PAC ID | 9133199714 |
|---|---|
| Medicare Enrollment ID | O20060322000047 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710182134 | NPI | - | NPPES |
| 173170501 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 24586 (Texas) | Primary |
| Provider Name | Alan Stephenson |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1235179359 PECOS PAC ID: 2769452341 Enrollment ID: I20060322000052 |
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