Basic Information
Provider Information
NPI: 1396488284
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: STEGMAN
FirstName: CURTIS
MiddleName: J
NamePrefix: MR.
NameSuffix:  
Credential: CAA
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 7200 CAMBRIDGE ST FL 10
Address2:  
City: HOUSTON
State: TX
PostalCode: 770304202
CountryCode: US
TelephoneNumber: 7137981750
FaxNumber: 7137984693
Practice Location
Address1: 7200 CAMBRIDGE ST FL 10
Address2:  
City: HOUSTON
State: TX
PostalCode: 770304202
CountryCode: US
TelephoneNumber: 7137981750
FaxNumber: 7137984693
Other Information
ProviderEnumerationDate: 04/18/2022
LastUpdateDate: 06/15/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 06/15/2022

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

No ID Information.


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