Healthcare Provider Details

I. General information

NPI: 1790027076
Provider Name (Legal Business Name): STACY LEE NAYES M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/25/2013
Last Update Date: 05/16/2022
Certification Date: 05/16/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17150 EL CAMINO REAL
HOUSTON TX
77058-2738
US

IV. Provider business mailing address

6431 FANNIN ST MSB 3.020
HOUSTON TX
77030-1501
US

V. Phone/Fax

Practice location:
  • Phone: 281-488-6347
  • Fax: 713-500-5805
Mailing address:
  • Phone: 713-500-5800
  • Fax: 713-500-5805

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberQ6775
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: