Healthcare Provider Details

I. General information

NPI: 1134404981
Provider Name (Legal Business Name): DOUGLAS STENNETT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/12/2011
Last Update Date: 10/12/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

851 N CENTRAL EXPY
PLANO TX
75075-8809
US

IV. Provider business mailing address

8416 OLD MCGREGOR RD
WACO TX
76712-6499
US

V. Phone/Fax

Practice location:
  • Phone: 972-578-2222
  • Fax:
Mailing address:
  • Phone: 254-537-4422
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: