Provider Demographics
NPI:1679624522
Name:STOCKS, ROBERT DENNIS (PA-C)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:DENNIS
Last Name:STOCKS
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9710 OBERRENDER RD
Mailing Address - Street 2:
Mailing Address - City:NEEDVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:77461-8963
Mailing Address - Country:US
Mailing Address - Phone:979-793-6391
Mailing Address - Fax:
Practice Address - Street 1:9630 CLAREWOOD DR
Practice Address - Street 2:SUITE A1
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77036-3512
Practice Address - Country:US
Practice Address - Phone:713-272-6688
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA 01857363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXP61053Medicare UPIN