Provider Demographics
NPI:1477792257
Name:STONE, SELMA ROXANNE (MD)
Entity Type:Individual
Prefix:DR
First Name:SELMA
Middle Name:ROXANNE
Last Name:STONE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:SELMA
Other - Middle Name:ROXANNE
Other - Last Name:SWAFFORD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:4233 FORBES DR
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-6613
Mailing Address - Country:US
Mailing Address - Phone:972-596-2848
Mailing Address - Fax:972-596-2609
Practice Address - Street 1:4233 FORBES DR
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-6613
Practice Address - Country:US
Practice Address - Phone:972-596-2848
Practice Address - Fax:972-596-2609
Is Sole Proprietor?:No
Enumeration Date:2009-02-18
Last Update Date:2009-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ6755207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX680603001OtherFEIN
TXG28498Medicare UPIN