Newly Listed Provider — this NPI profile has been added to the NPI registry within the last 90 days.

STEPHAINE E LILIEDAHL IDMT
NPI 1063338903
Military Health Care Provider - Independent Duty Medical Technicians in San Antonio, TX

Active since June 25, 2026
3551 ROGER BROOKE DR, SAN ANTONIO, TX 78234(210) 916-1723 Get Directions Write a Review

NPPES record added: June 25, 2026. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Stephaine E Liliedahl Idmt NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

STEPHAINE E LILIEDAHL IDMT (NPI 1063338903) is an individual independent duty medical technicians provider in San Antonio, Texas and active in the NPI registry since June 2026.

NPPES Registry Identity

NPI1063338903
Entity TypeIndividualFemale
Primary Taxonomy1710I1003X
Provider Legal NameSTEPHAINE E LILIEDAHLCredential: IDMT
Location Address3551 ROGER BROOKE DRSan Antonio, TX 78234-4504
Mailing Address3551 Roger Brooke DrSan Antonio, TX 78234-4504
Sole ProprietorNo
Enumeration DateJune 25, 2026
NPPES CertifiedJune 25, 2026
NPI 1063338903 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Taxonomy Code1710I1003X
Definition
An Independent Duty Medical Technician (IDMT) is specially trained and educated to perform primary medical care, minor surgical services, and treatment of dental disorders for active duty military members in a variety of health care and non-health care settings worldwide under direct and indirect physician supervision. An IDMT may take medical histories, perform physical exams, order lab tests and x-rays, prescribe medications, and give immunizations. IDMTs work under the direct supervision of a physician preceptor when at home station and indirectly when assigned to a Mobile Aid Station, Mobile Medical Unit, remote site, or otherwise deployed specifically as an IDMT. An IDMT may be an experienced Aerospace Medical Service Technician who meets special task qualifications and is recommended for training by the Aerospace Medical Service Functional Manager at their Medical Treatment Facility. IDMTs maintain certification as Nationally Registered Emergency Medical Technicians and as Immunization Back-up Technicians.
3551 ROGER BROOKE DR, San Antonio, TX 78234

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Nurse Anesthetist, Certified Registered
3551 ROGER BROOKE DR
FORT SAM HOUSTON, TX 78234
Physician Assistant
3551 ROGER BROOKE DR
JBSA FT SAM HOUSTON, TX 78234
Pediatrics (Pediatric Endocrinology)
3551 ROGER BROOKE DR
FORT SAM HOUSTON, TX 78234
Social Worker (Clinical)
3551 ROGER BROOKE DR
FORT SAM HOUSTON, TX 78234
Neurological Surgery
3551 ROGER BROOKE DR
FORT SAM HOUSTON, TX 78234
Social Worker (Clinical)
3551 ROGER BROOKE DR
FORT SAM HOUSTON, TX 78234
Ophthalmology
3551 ROGER BROOKE DR
JBSA FORT SAM HOUSTON, TX 78234
Emergency Medicine (Emergency Medical Services)
3551 ROGER BROOKE DR
FORT SAM HOUSTON, TX 78234

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Stephaine Liliedahl's NPI number?

The NPI number for Stephaine Liliedahl is 1063338903. It was assigned to this individual provider in the NPPES registry on June 25, 2026.

Where is Stephaine Liliedahl located?

Stephaine Liliedahl practices at 3551 Roger Brooke Dr, San Antonio, TX 78234. The listed phone number is (210) 916-1723.

What is Stephaine Liliedahl's specialty?

The primary specialty registered for this NPI is Military Health Care Provider, specializing in Independent Duty Medical Technicians, with taxonomy code 1710I1003X.

When was this NPI record last updated?

The NPPES record for Stephaine Liliedahl was last updated on June 25, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 60 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.