| Td Stanley Pllc | |
|
1603 Holly St Atlanta TX 75551-1840 | |
| (903) 824-4471 | |
| Not Available |
| Full Name | Td Stanley Pllc |
|---|---|
| Speciality | Counselor |
| Location | 1603 Holly St, Atlanta, Texas |
| Authorized Official Name and Position | Timothy Stanley (OWNER) |
| Authorized Official Contact | 9038244471 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Td Stanley Pllc 1603 Holly St Atlanta TX 75551-1840 Ph: () - | Td Stanley Pllc 1603 Holly St Atlanta TX 75551-1840 Ph: (903) 824-4471 |
| NPI Number | 1760246854 |
|---|---|
| Provider Enumeration Date | 02/08/2024 |
| Last Update Date | 02/08/2024 |
| Certification Date | 02/08/2024 |
| Medicare PECOS PAC ID | 6002251964 |
|---|---|
| Medicare Enrollment ID | O20240301000091 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760246854 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
| Provider Name | Timothy D Stanley |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1538113402 PECOS PAC ID: 2769788975 Enrollment ID: I20240326000711 |
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