Healthcare Provider Details

I. General information

NPI: 1790787190
Provider Name (Legal Business Name): JAMES T STINNETT M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/15/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3106 S W S YOUNG DR SUITE 201B
KILLEEN TX
76542-2000
US

IV. Provider business mailing address

3500 S IH 35
BELTON TX
76513-9426
US

V. Phone/Fax

Practice location:
  • Phone: 254-519-4162
  • Fax: 254-519-3464
Mailing address:
  • Phone: 254-939-2100
  • Fax: 254-939-2334

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberD3411
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: