Provider Demographics
NPI:1902893548
Name:ESTES, STEPHEN B (DC)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:B
Last Name:ESTES
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 443
Mailing Address - Street 2:
Mailing Address - City:MC DADE
Mailing Address - State:TX
Mailing Address - Zip Code:78650-0443
Mailing Address - Country:US
Mailing Address - Phone:512-423-5055
Mailing Address - Fax:
Practice Address - Street 1:757 MARLIN ST
Practice Address - Street 2:
Practice Address - City:MC DADE
Practice Address - State:TX
Practice Address - Zip Code:78650-5062
Practice Address - Country:US
Practice Address - Phone:512-423-5055
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-09-29
Last Update Date:2020-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2879111NX0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NX0800XChiropractic ProvidersChiropractorOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
T13197Medicare UPIN