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General NPI Number Information
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NPI Number | 1225334790
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Entity Type | Individual
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Provider Name | JAMES ROBERT STOCKMAN JR. CRNA
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Gender | Male
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Dates
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Enumeration Date | 02/01/2011
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Last Update Date | 03/04/2025
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Provider Practice Location Address
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Address Line | 1023 N MOUND ST STE A
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City | NACOGDOCHES
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State | TX
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Zip | 75961-4453
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Country | US
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Telephone | 936-564-8611
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Fax | 936-564-4155
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Provider Business Mailing Address
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Address Line | 2400 N STALLINGS DR STE 405
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City | NACOGDOCHES
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State | TX
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Zip | 75964-1222
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Country | US
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Telephone | 936-254-4703
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Fax | 936-560-6933
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number | AP119935
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 712738
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | AP119935
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License Number State | TX
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