Provider Demographics
NPI:1235267493
Name:STANLEY J POOL MD PA
Entity Type:Organization
Organization Name:STANLEY J POOL MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:STANLEY
Authorized Official - Middle Name:J
Authorized Official - Last Name:POOL MD PA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:713-649-0041
Mailing Address - Street 1:8951 RUTHBY ST
Mailing Address - Street 2:STE 5
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77061-3141
Mailing Address - Country:US
Mailing Address - Phone:713-649-0041
Mailing Address - Fax:713-645-1916
Practice Address - Street 1:8951 RUTHBY ST
Practice Address - Street 2:STE 5
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77061-3141
Practice Address - Country:US
Practice Address - Phone:713-649-0041
Practice Address - Fax:713-645-1916
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-01
Last Update Date:2014-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF0286207P00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX033282703Medicaid
TX299285102Medicaid
TX1467461525OtherTYPE 1
TX299285101Medicaid