Provider Demographics
NPI:1497908990
Name:STACY, CURTIS III (DC, FIAMA)
Entity Type:Individual
Prefix:DR
First Name:CURTIS
Middle Name:
Last Name:STACY
Suffix:III
Gender:M
Credentials:DC, FIAMA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1010 W JASPER DR STE 1
Mailing Address - Street 2:
Mailing Address - City:KILLEEN
Mailing Address - State:TX
Mailing Address - Zip Code:76542-1328
Mailing Address - Country:US
Mailing Address - Phone:254-200-0401
Mailing Address - Fax:254-200-0405
Practice Address - Street 1:1010 W JASPER DR STE 1
Practice Address - Street 2:
Practice Address - City:KILLEEN
Practice Address - State:TX
Practice Address - Zip Code:76542-1328
Practice Address - Country:US
Practice Address - Phone:254-200-0401
Practice Address - Fax:254-200-0405
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-28
Last Update Date:2017-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX8758111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX584770YY3LOtherMEDICARE
TXC-06039379Medicaid