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General NPI Number Information
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NPI Number | 1053500082
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Entity Type | Organization
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Legal Business Name | SPECIALITY AMBULATORY CENTER OF TEXAS
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Dates
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Enumeration Date | 10/16/2007
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Last Update Date | 10/16/2007
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Provider Practice Location Address
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Address Line | 2821 E PRESIDENT GEORGE BUSH HWY STE 103
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City | RICHARDSON
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State | TX
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Zip | 75082-4277
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Country | US
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Telephone | 972-276-6300
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Fax |
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Provider Business Mailing Address
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Address Line | 6505 W. PARK BLVD. #306 (285)
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City | PLANO
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State | TX
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Zip | 75093
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Country | US
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Telephone | 972-276-6300
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Fax |
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Authorized Official
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Title or Position | DR.
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Name | DR. STANLEY W. WHISENANT
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Credential | M.D.
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Telephone | 972-276-6300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP3300X
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Taxonomy Name | Pain Clinic/Center
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License Number | J7725
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number | J7725
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License Number State | TX
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