Provider Demographics
NPI:1821145996
Name:BELCHER, STACEY ROSE (MD)
Entity Type:Individual
Prefix:DR
First Name:STACEY
Middle Name:ROSE
Last Name:BELCHER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:379 FM 2972 W
Mailing Address - Street 2:
Mailing Address - City:RUSK
Mailing Address - State:TX
Mailing Address - Zip Code:75785-3666
Mailing Address - Country:US
Mailing Address - Phone:903-253-7680
Mailing Address - Fax:903-565-6087
Practice Address - Street 1:379 FM 2972 W
Practice Address - Street 2:
Practice Address - City:RUSK
Practice Address - State:TX
Practice Address - Zip Code:75785-3666
Practice Address - Country:US
Practice Address - Phone:903-683-5781
Practice Address - Fax:903-565-6087
Is Sole Proprietor?:No
Enumeration Date:2007-01-04
Last Update Date:2023-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK02592084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8F2825Medicare ID - Type Unspecified
TXG98220Medicare UPIN