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Deactivated NPI 1477699205 Deactivated / Inactive NPI Male Practitioner

Dr. Stephen Frank Waller , MD

Specialist • Conroe, TX

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. Stephen Waller has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date January 29, 2007
NPI Deactivation Date October 21, 2020
Total Practice Duration ~13 Years of Practice (2007 – 2020)

Professional Overview & Biography Verified Profile Summary

Dr. Stephen Waller, MD was a registered Specialist practicing in Conroe, TX. Throughout an active medical career spanning 13 years, Dr. Waller provided care at the practice location at 333 N RIVERSHIRE DR until profile deactivation on 2020-10-21.

Practice Location & Contact Primary Location

Practice Address

333 N Rivershire Dr
Suite 265

Conroe, TX 773040001

Telephone 9365396771
Associated Practice Facility / Clinic
🏢 Conroe Eye Clinic, Llp Facility NPI 1497707905

Specialty Benchmarks & Practice Insights

Comparative analytics for Specialist in Conroe, TX

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 34.0 Yrs
State Avg: 38.0 Yrs
Regional Practice Density
13 Specialists

Practicing in Conroe, TX (2033 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Specialist Primary Specialty

NUCC Taxonomy Code: 174400000X

State License TX F8724

An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

6 Associated Practitioners
Dr. Linda Hyde , MD

Family Medicine

NPI 1033177944

Doctor of Medicine (M.D.)

Robin Ruzic

Speech-Language Pathologist

NPI 1104215094
Dr. Michael Higgins , DDS

Dentist - General Practice

NPI 1154758555

Doctor of Dental Surgery

NPI 1447291158

Doctor of Medicine (M.D.)

Dr. Christopher Burton , DDS

Dentist - General Practice

NPI 1598172991

Doctor of Dental Surgery

Dr. Ronald Massey , PhD

Psychologist - Clinical

NPI 1861429565

Doctor of Philosophy (Ph.D.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated October 21, 2020

Record deactivated on October 21, 2020

NPI Profile Active July 08, 2007

NPI status registered as active in NPPES database

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Updated Practice Location July 08, 2007

Registered at 333 N RIVERSHIRE DR, SUITE 265, CONROE, TX 773040001 (Tel: 9365396771)

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Updated Business Mailing Address July 08, 2007

Registered at 333 N RIVERSHIRE DR, SUITE 265, CONROE, TX 773040001 (Tel: 9365396771)

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Provider Name / Credentials Updated July 08, 2007

Recorded as STEPHEN WALLER, M.D.

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Medical Taxonomy / Specialty Registered (Primary Specialty) July 08, 2007

Specialist (License #F8724 in TX)

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Initial NPI Registration & Enumeration January 29, 2007

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1477699205
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: January 29, 2007
Last Update: July 08, 2007
Deactivation Date: October 21, 2020

Mailing Address

333 N Rivershire Dr, Suite 265

Conroe, TX 773040001

Phone: 9365396771

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.