Provider Demographics
NPI:1033621347
Name:WALKER, STANLEY DEAN JR (PMHNP, RN, MSN)
Entity type:Individual
Prefix:
First Name:STANLEY
Middle Name:DEAN
Last Name:WALKER
Suffix:JR
Gender:M
Credentials:PMHNP, RN, MSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12036 CASTLEFORD WAY
Mailing Address - Street 2:
Mailing Address - City:CROWLEY
Mailing Address - State:TX
Mailing Address - Zip Code:76036-2869
Mailing Address - Country:US
Mailing Address - Phone:915-471-9356
Mailing Address - Fax:
Practice Address - Street 1:12036 CASTLEFORD WAY
Practice Address - Street 2:
Practice Address - City:CROWLEY
Practice Address - State:TX
Practice Address - Zip Code:76036-2869
Practice Address - Country:US
Practice Address - Phone:915-471-9356
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-26
Last Update Date:2017-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP135608363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health