Provider Demographics
NPI:1447245709
Name:STASNEY, C RICHARD (MD)
Entity Type:Individual
Prefix:
First Name:C
Middle Name:RICHARD
Last Name:STASNEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6550 FANNIN ST
Mailing Address - Street 2:STE 2025
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-2717
Mailing Address - Country:US
Mailing Address - Phone:713-796-2181
Mailing Address - Fax:713-796-2349
Practice Address - Street 1:6550 FANNIN ST
Practice Address - Street 2:STE 2025
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-2717
Practice Address - Country:US
Practice Address - Phone:713-796-2181
Practice Address - Fax:713-796-2349
Is Sole Proprietor?:No
Enumeration Date:2005-09-13
Last Update Date:2012-10-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXD6183207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXB158353OtherMEDICARE ID NUMBER
TXB158353OtherMEDICARE ID NUMBER