Individual ProviderStephanie Targac CortesNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address1301 W 38th St, Suite 400, Austin, TX 78705-1000(512) 324-3440(512) 324-8960PECOS EnrollmentBased on the most recent information from CMS, provider Stephanie Targac Cortes is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records 5 days ago.Profile DetailsProvider ID1235507757Provider TypeIndividualFull NameTargac Cortes, StephanieCredentialFNP-CGenderFemaleSole ProprietorNoEnumeration Date9/15/2015Last Updated11/19/2015Contact InformationPractice LocationPractice Address1301 W 38th St, Suite 400, Austin, TX 78705-1000Phone(512) 324-3440Fax(512) 406-6513Mailing LocationMailing Address4616 W Howard Ln, Austin, TX 78728-6300Phone(512) 324-8960Fax(512) 324-8906Provider TaxonomiesCodeDescriptionLicenseCode363LF0000XPrimaryDescriptionNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersLicenseAP128461TexasProvider IdentifiersIDDescriptionIssuerID8919NRDescriptionOtherIssuerBCBSTexas