Stanley, Kathleen
Stanley, Kathleen is an individual health care provider with primary practice located at 3601 4Th St Suite 1C102, Lubbock TX 79430-0002. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Psychiatry, Allopathic & Osteopathic Physicians / Addiction Psychiatry. Allopathic & Osteopathic Physicians / Psychiatry is her primary health care specialty. Stanley, Kathleen can be contacted via phone (806) 743-2800.Contact Information
Primary practice address
3601 4Th St Suite 1C102
Lubbock TX 79430-0002
Phone: (806) 743-2800
Fax: (806) 743-1668
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Psychiatry | 2084P0800X | G1268 | Texas |
| Allopathic & Osteopathic Physicians / Addiction Psychiatry | 2084P0802X | G1268 | Texas |
Profile Details
| NPI number | 1306822689 |
|---|---|
| LBN Legal business name | Stanley, Kathleen |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 19th, 2005 |
| Last updated | Jul 13th, 2007 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1306822689 | NPPES |
| New Mexico | MEDICAID | 22304550 | |
| New Mexico | MEDICAID | 114700104 | |
| New Mexico | MEDICAID | 100845570A |
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