Provider Demographics
NPI:1922310911
Name:STALLING, SIMONE (MD)
Entity Type:Individual
Prefix:
First Name:SIMONE
Middle Name:
Last Name:STALLING
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 1:915 GESSNER RD STE 500
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77024-2568
Mailing Address - Country:US
Mailing Address - Phone:713-468-0303
Mailing Address - Fax:713-468-0307
Practice Address - Street 1:915 GESSNER RD STE 500
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77024-2568
Practice Address - Country:US
Practice Address - Phone:713-468-0303
Practice Address - Fax:713-468-0307
Is Sole Proprietor?:No
Enumeration Date:2010-07-08
Last Update Date:2019-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMT197636207R00000X
TXP9743207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine