Stediclinic PLLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

STEDICLINIC PLLC

Practice address

4560 FM 1960 Rd W Ste 106
Houston, TX 77069

Phone

(832) 286-1061

Fax

(832) 286-1267

NPI assigned

Dec 2, 2015

Last updated

Jun 26, 2018By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Olayinka Agbodo, FNP

Title

Family Nurse Practitioner

Phone

(832) 745-8742

Specialties & licenses 3

Addresses

Other identifiers 3

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/13151/brand/1/csg/1/fhir/r4

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1449014400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529971200000",
    "number": "1659746675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4560 FM 1960 RD W STE 106",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770694628",
            "telephone_number": "832-286-1061",
            "fax_number": "832-286-1267"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4560 FM 1960 RD W STE 106",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "77069",
            "telephone_number": "832-286-1061",
            "fax_number": "832-286-1267"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STEDICLINIC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-02",
        "last_updated": "2018-06-26",
        "status": "A",
        "authorized_official_last_name": "AGBODO",
        "authorized_official_first_name": "OLAYINKA",
        "authorized_official_title_or_position": "FAMILY NURSE PRACTITIONER",
        "authorized_official_telephone_number": "832-745-8742",
        "authorized_official_credential": "FNP"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "TX",
            "license": null,
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP128483",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP130092",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "358389004",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1659746675",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3604894",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Judith Rene Steans, LCSW
• Kathleen Malone Stearns, LCSW
• Mary Margaret Stearns, LMSW
• Thomas Joseph Stearns, LCSW
• Dana Steck, MA, CCC-SLP
• Amy Cheryl Stedifor-Lee, M.A. CCC-SLP
• George Steed, O.D.
• Tanner Isaak Steed, PA-C
• Jacque Elaine Steede, CRNA
• Cameron D Steel

• Clinic/Center in Houston, TX
• Providers in Houston, TX by specialty
• Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.