Provider Demographics
NPI:1023363249
Name:STANLEY, DOUGLAS JAMES (MD)
Entity type:Individual
Prefix:DR
First Name:DOUGLAS
Middle Name:JAMES
Last Name:STANLEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:9200 PINECROFT DR STE 425
Mailing Address - Street 2:
Mailing Address - City:SHENANDOAH
Mailing Address - State:TX
Mailing Address - Zip Code:77380-3285
Mailing Address - Country:US
Mailing Address - Phone:713-486-5231
Mailing Address - Fax:713-486-0850
Practice Address - Street 1:9200 PINECROFT DR STE 425
Practice Address - Street 2:
Practice Address - City:SHENANDOAH
Practice Address - State:TX
Practice Address - Zip Code:77380-3285
Practice Address - Country:US
Practice Address - Phone:134-865-2317
Practice Address - Fax:713-486-0850
Is Sole Proprietor?:No
Enumeration Date:2012-07-14
Last Update Date:2023-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
TXQ0572207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX354141YNQ4Medicare PIN