Provider Demographics
NPI:1598835589
Name:ISDALE, STANLEY EUGENE (DC)
Entity Type:Individual
Prefix:DR
First Name:STANLEY
Middle Name:EUGENE
Last Name:ISDALE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 W. CENTRAL TEXAS EXPWY
Mailing Address - Street 2:SUITE 104
Mailing Address - City:HARKER HEIGHTS
Mailing Address - State:TX
Mailing Address - Zip Code:76548
Mailing Address - Country:US
Mailing Address - Phone:254-699-3303
Mailing Address - Fax:254-699-7519
Practice Address - Street 1:100 W. CENTRAL TEXAS EXPWY
Practice Address - Street 2:SUITE 104
Practice Address - City:HARKER HEIGHTS
Practice Address - State:TX
Practice Address - Zip Code:76548
Practice Address - Country:US
Practice Address - Phone:254-699-3303
Practice Address - Fax:254-699-7519
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDC 5329111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXDC 5329OtherSTATE LICENSE
TXDC 5329OtherSTATE LICENSE