Stephen C. Watson Jr., DDS, MS, PC

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

17664 Issued in TX

Practice address

4724 Sweetwater Blvd
Suite #101
Sugar Land, TX 77479-3149

Phone

(281) 491-5655

Fax

(281) 491-0058

NPI assigned

Apr 4, 2007

Sex

Male

Sole proprietor

Yes

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Previously, effective Aug 31, 2016 through Aug 31, 2026

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 8, 2007.

{
    "created_epoch": "1175644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1073635637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4724 SWEETWATER BLVD",
            "address_2": "SUITE #101",
            "city": "SUGAR LAND",
            "state": "TX",
            "postal_code": "774793149",
            "telephone_number": "281-491-5655",
            "fax_number": "281-491-0058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4724 SWEETWATER BLVD",
            "address_2": "SUITE #101",
            "city": "SUGAR LAND",
            "state": "TX",
            "postal_code": "774793149",
            "telephone_number": "281-491-5655",
            "fax_number": "281-491-0058"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATSON",
        "first_name": "STEPHEN",
        "middle_name": "C.",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "DDS, MS, PC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "TX",
            "license": "17664",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Syeda Zainab Wasti, M.D.
• Watershed Group of Houston PLLC Dba Lifeologie
• Kai Watson
• Kristen Renee Watson, CCC-SLP
• Lilian Freitas Watson, OT
• Blake Motley Watts, M.D.
• Summer Dawn Waugh, CNP
• Wave Medical Solutions LLC
• Elisa Wawi, RBT
• Anisha Vakil Waxali, MD

• All providers in Sugar Land, TX
• Periodontics in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.