MEDICARE: DR. TIMOTHY T STOCK M.D.

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	2084N0400X	Neurology Physician	K5705	TX
2	2084P0800X	Psychiatry Physician	K5705	TX

General Provider Information

NPI Number	:	1568447944
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TIMOTHY T STOCK M.D.

Provider Business Mailing Address
First Line	:	4600 SAMUELL BLVD
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75228-6874
Country	:	US
Telephone Number	:	214-275-8500
Fax Number	:	214-388-3800

Provider Business Practice Location Address
First Line	:	4600 SAMUELL BLVD
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75228-6874
Country	:	US
Telephone Number	:	214-275-8500
Fax Number	:	214-388-3800

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/08/2005
Last Update Date	:	05/18/2009

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Directions to “ DR. TIMOTHY T STOCK M.D.” Practice Location

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