Stavchansky, Marcus M
Stavchansky, Marcus M is an sole proprietor health care provider with primary practice located at 1341 W Mockingbird Ln Suite #400 E, Dallas TX 75247-6913. He recently has only one registered license in Pharmacy Service Providers / Pharmacist, which is considered as his primary health care specialty. Stavchansky, Marcus M can be contacted via phone (214) 647-9312.Contact Information
Primary practice address
1341 W Mockingbird Ln Suite #400 E
Dallas TX 75247-6913
Phone: (214) 647-9312
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Pharmacy Service Providers / Pharmacist | 183500000X | 39396 | Texas |
Profile Details
| NPI number | 1073654661 |
|---|---|
| LBN Legal business name | Stavchansky, Marcus M |
| Credentials | PHARM.D. |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Feb 8th, 2007 |
| Last updated | Jul 11th, 2012 - about 13 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 | 1073654661 | NPPES |
| Texas | Other | 39396 | PHARMACY LICENSE |
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