Healthcare Provider Details

I. General information

NPI: 1710818208
Provider Name (Legal Business Name): RICHARD STANLEY
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/26/2026
Last Update Date: 05/26/2026
Certification Date: 05/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4616 US HWY 75 # 203
DENISON TX
75020-4513
US

IV. Provider business mailing address

1530 W HULL ST
DENISON TX
75020-5237
US

V. Phone/Fax

Practice location:
  • Phone: 903-462-6310
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number1234801
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: