MEDICARE: STONE & ASSOCIATES LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	164X00000X	Licensed Vocational Nurse	157415	TX
2	246RP1900X	Phlebotomy Technician	157415	TX
3	246RM2200X	Medical Laboratory Technician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	246RP1900X	OTHER	TX	PHLEBOTOMIST
2	291U00000X	OTHER	TX	CLINICAL MEDICAL LABORATORY
3	164X00000X	OTHER	TX	LICENSED VOCATIONAL NURSE
4	157415	OTHER	TX	LICENSED VOCATIONAL NURSE

General Provider Information

NPI Number	:	1497231682
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	STONE & ASSOCIATES LLC

Provider Business Mailing Address
First Line	:	2900 RACE ST APT 158
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76111-4171
Country	:	US
Telephone Number	:	817-863-4676
Fax Number	:	469-342-8232

Provider Business Practice Location Address
First Line	:	6326 BRENTWOOD STAIR RD
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76112-3136
Country	:	US
Telephone Number	:	817-953-2431
Fax Number	:	469-342-8232

Authorized Official
Title or Position	:	OWNER
Name	:	NICOLE POLLARD
Credential	:	LVN
Telephone Number	:	817-863-4676

Provider Enumeration Date	:	07/11/2018
Last Update Date	:	10/07/2020

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Directions to “STONE & ASSOCIATES LLC ” Practice Location

Language	Start Address	Practice Location

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