Jack B Stephenson, MD

Plastic surgeon in Tyler, Texas · NPI 1972624542

Jack Stephenson is one of 8 plastic surgeons practicing in Tyler, Texas. Jack Stephenson practices with Christus Trinity Clinic.

Registry record (NPPES)

NPI
1972624542
Type
Type 1 · Individual
Primary taxonomy
Plastic Surgery, Surgery of the Hand · 2082S0105X
Address on file
8591 S Broadway Ave
Tyler, TX 75703-5470
(903) 596-9173
Enumerated
Apr 2, 2007
Record last updated
Nov 19, 2024
License states listed
TX

Medicare (CMS)

Enrollment
Medicare-enrolled in TX
Plastic and Reconstructive Surgery
Revalidation due
No date set by CMS

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  • Full enrollment history
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Practice locations

More plastic surgeons in Tyler

Updated August 2026. Practice locations and specialty come from the CMS Doctors and Clinicians file, the registry record from NPPES, and enrollment from CMS Medicare enrollment files. NPI records are corrected at the source, through NPPES.