MEDICARE: SIMONE STALLING MD

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	207R00000X	Internal Medicine Physician	MT197636	PA
2	207N00000X	Dermatology Physician	P9743	TX

General Provider Information

NPI Number	:	1922310911
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SIMONE STALLING MD

Provider Business Mailing Address
First Line	:	915 GESSNER RD STE 500
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77024-2568
Country	:	US
Telephone Number	:	713-468-0303
Fax Number	:	713-468-0307

Provider Business Practice Location Address
First Line	:	915 GESSNER RD STE 500
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77024-2568
Country	:	US
Telephone Number	:	713-468-0303
Fax Number	:	713-468-0307

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

Provider Enumeration Date	:	07/08/2010
Last Update Date	:	02/21/2019

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Directions to “ SIMONE STALLING MD” Practice Location

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