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Contact Information

IGNATIUS P DISTEFANO
1500 CITYWEST BLVD
STE. 300
HOUSTON, TX77042-2300
 Phone: 713-620-4000
 Fax: 713-458-4229
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Anesthesiology

207L00000X 79 Physician/Addiction Medicine
Indicates primary specialty

NPI Profile & details for IGNATIUS P DISTEFANO · (Male)

NPI Number 1013066232
Status Active
Credentials
Entity Individual
Enumeration date 01/09/2007
Last updated 02/23/2017 - About 3 years ago
Sole proprietor 1 No
Identifiers
  • TX License # G1887
  • LA Medicaid 1543781
  • TX Medicaid 128192503
  • Other 84Y539 TX-BLUE SHIELD
  • TX Other 050041650 RAILROAD MEDICARE
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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