Provider Demographics
NPI:1740972603
Name:ADAMS, STEVAN ROBERT REECE (REGISTERED NURSE)
Entity type:Individual
Prefix:MR
First Name:STEVAN
Middle Name:ROBERT REECE
Last Name:ADAMS
Suffix:
Gender:M
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5900 BALCONES DR STE 100
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78731-4298
Mailing Address - Country:US
Mailing Address - Phone:210-682-9156
Mailing Address - Fax:210-957-1119
Practice Address - Street 1:14115 KINGS MDWS
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78231-1717
Practice Address - Country:US
Practice Address - Phone:210-682-9156
Practice Address - Fax:210-957-1119
Is Sole Proprietor?:No
Enumeration Date:2023-05-22
Last Update Date:2023-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX956600163WH0200X, 163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No163WH0200XNursing Service ProvidersRegistered NurseHome Health