Stacy Renee Fonner, is a
Speech-language Pathologist based in Canyon Lake, Texas. Stacy Renee Fonner is licensed to practice in Texas (license number 117945) and her current practice location is
310 Cannan Rd, Canyon Lake, Texas. She can be reached at her office (for appointments etc.) via phone at
(830) 885-9516.
NPI number for Stacy Renee Fonner is 1750022182 and her current mailing address is 322 Lets Roll Drive, Fischer, Texas. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1750022182.
Healthcare Provider's Profile
| Full Name | Stacy Renee Fonner |
|---|
| Gender | Female |
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| Speciality | Speech-language Pathologist |
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| Location | 310 Cannan Rd, Canyon Lake, Texas |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1750022182
- Provider Enumeration Date: 04/07/2022
- Last Update Date: 04/07/2022
Medical Identifiers
Medical identifiers for Stacy Renee Fonner such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1750022182 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 235Z00000X | Speech-language Pathologist | 117945 (Texas) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Stacy Renee Fonner is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Stacy Renee Fonner,
322 Lets Roll Drive,
Fischer, TX 78623
Ph: (732) 674-7301 | Stacy Renee Fonner,
310 Cannan Rd,
Canyon Lake, TX 78133-4552
Ph: (830) 885-9516 |
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