Provider Demographics
NPI:1003445867
Name:STANLEY, BRIAN ALLAN (MD, PHD)
Entity Type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:ALLAN
Last Name:STANLEY
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1321 UPLAND DR # 2362
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77043-4718
Mailing Address - Country:US
Mailing Address - Phone:443-564-3691
Mailing Address - Fax:
Practice Address - Street 1:8268 164TH ST BLDG 7TH
Practice Address - Street 2:
Practice Address - City:JAMAICA
Practice Address - State:NY
Practice Address - Zip Code:11432-1121
Practice Address - Country:US
Practice Address - Phone:718-883-4583
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-03
Last Update Date:2020-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program