Provider Demographics
NPI:1538436977
Name:DANIELS, STEPHEN EUGENE (DO)
Entity type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:EUGENE
Last Name:DANIELS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3200 RED RIVER ST
Mailing Address - Street 2:SUITE 300
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78705-2660
Mailing Address - Country:US
Mailing Address - Phone:512-320-1600
Mailing Address - Fax:
Practice Address - Street 1:3200 RED RIVER ST
Practice Address - Street 2:SUITE 300
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78705-2660
Practice Address - Country:US
Practice Address - Phone:512-320-1600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-30
Last Update Date:2011-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH6149207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine