Provider Demographics
NPI:1255223210
Name:STELZIG, STEPHEN WAYNE
Entity type:Individual
Prefix:MR
First Name:STEPHEN
Middle Name:WAYNE
Last Name:STELZIG
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4103 CALLOWAY DR
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:TX
Mailing Address - Zip Code:76063-3465
Mailing Address - Country:US
Mailing Address - Phone:469-569-2793
Mailing Address - Fax:972-364-1245
Practice Address - Street 1:4103 CALLOWAY DR
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:TX
Practice Address - Zip Code:76063-3465
Practice Address - Country:US
Practice Address - Phone:469-569-2793
Practice Address - Fax:972-364-1245
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-16
Last Update Date:2025-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1003488332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies