Provider Demographics
NPI:1700924156
Name:HAMID, STACY ELISE (MD)
Entity Type:Individual
Prefix:
First Name:STACY
Middle Name:ELISE
Last Name:HAMID
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 1:6352 BUSHWOODS DR
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75034-3447
Mailing Address - Country:US
Mailing Address - Phone:972-375-2393
Mailing Address - Fax:
Practice Address - Street 1:6352 BUSHWOODS DR
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75034-3447
Practice Address - Country:US
Practice Address - Phone:972-375-2393
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-01
Last Update Date:2012-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN-5095208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice