MR. STACY LEE BLACK (NPI# 1063423085) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063423085 |
| Entity Type | Individual |
| Full Name | MR. STACY LEE BLACK |
| Credential | DDS PA |
| Practice Address |
132 Hatchett St. Rusk TX 75785 |
| Mailing Address |
Po Box 316 Rusk TX 75785-0316 |
| Practice Telephone | 9036835751 |
| Practice Fax Number | 9036833455 |
| Mailing Telephone | 9036835751 |
| Mailing Fax Number | 9036833455 |
| Enumeration Date | 2006-08-11 |
| Last Update Date | 2015-04-09 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
17132 | TX | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | 009120901 | 05 | |
| TX | DENT | 36871 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104320480 | Stacy Anne Black | Marriage & Family Therapist | 2301 Old Hwy 99, Mt. Vernon, WA 98273 | 2018-03-21 |
| 1982890844 | Stacy Renee Black | Physical Therapist | 9108 Los Arboles Ave Ne, Albuquerque, NM 87112-1267 | 2007-09-24 |
| 1316544141 | Stacy Black | Case Manager/Care Coordinator | 2455 Sutherland Ave, Knoxville, TN 37919-2355 | 2020-10-05 |
| Street Address |
132 HATCHETT ST. |
| City | RUSK |
| State | TX |
| Zip Code | 75785 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841898137 | Pineywoods Physical Therapy LLC | Clinic/Center | 1400 West 6th Street, Suite 6 and 7, Rusk, TX 75785 | 2020-10-09 |
| 1184124943 | Deanna Adams | Nurse Practitioner | 1884 Fm343, Rusk, TX 75785 | 2018-02-19 |
| 1831584598 | Stacy Black, Dds, Pa | Dentist | 132 Hatchett, Rusk, TX 75785 | 2015-03-31 |
| 1770823759 | Kristina L Waggoner | Nurse Practitioner | 805 North Dickinson Drive, Rusk, TX 75785 | 2013-02-27 |
| 1104146257 | Rebecca Ann Vogt | Speech-Language Pathologist | 2205 East Johnson St., Rusk, TX 75785 | 2010-06-10 |
| 1710179569 | Julana Graham Schwartz | Speech-Language Pathologist | 2205 Johnson Dr., Rusk, TX 75785 | 2007-08-15 |
| 1154443844 | Alva Joy Jones | Counselor | 1400 Hwy 84 West, Cherokee Center, Suite 3, Rusk, TX 75785 | 2007-04-04 |
| 1902946916 | Stanley Self | Psychiatry & Neurology | 1601 North Dickinson Drive, Rusk, TX 75785 | 2007-02-07 |
| 1396895728 | Satyajeet Lahiri | Psychiatry & Neurology | 1601 N Dickinson Drive, Rusk, TX 75785 | 2007-01-10 |
| 1619039641 | Harry Thompson | Psychiatry & Neurology | 1601 Dickinson Drive, Rusk, TX 75785 | 2006-12-15 |
| Find all providers in zip 75785 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477184802 | Rusk Dental Pllc | Dentist | 516 N Dickinson Dr Ste B, Rusk, TX 75785-1063 | 2020-02-04 |
| 1831584598 | Stacy Black, Dds, Pa | Dentist | 132 Hatchett, Rusk, TX 75785 | 2015-03-31 |
| 1962794008 | James Blaine Manker | Dentist | 805 N Dickinson Drive, Rusk, TX 75785-0000 | 2011-05-09 |
| 1518040757 | Gerald R Ocker | Dentist | 971 W 6th St, Rusk, TX 75785-1184 | 2006-10-23 |
| 1053531673 | Louis Kavetski | Dentist | 1601 N Dickinson, Rusk, TX 75785 | 2007-04-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306447537 | Azle Cube Smiles Pllc | Dentist | 100 Park Plc Ste 224, Azle, TX 76020 | 2020-11-04 |
| 1548860257 | Emeka Abazie Dds Pa | Dentist | 1001 N. Beckley, Suite 304, Desoto, TX 75115 | 2020-10-30 |
| 1699375543 | Long Family Dental | Dentist | 4470 E Highway 287 Ste 1200, Midlothian, TX 76065-7556 | 2020-10-29 |
| 1548860992 | Vequinox Pllc | Dentist | 2605 N Shary Rd, Mission, TX 78574-3221 | 2020-10-27 |
| 1952900466 | Gwendolyn Kines-mcleod Dds,pllc | Dentist | 401 N Ann St Ste B, Terrell, TX 75160-2549 | 2020-10-26 |
| 1609476183 | Texas Saas Pa | Dentist | 3839 Mckinney Ave Ste 130, Dallas, TX 75204-1489 | 2020-10-26 |
| 1295334803 | Jpm Dental of Spring | Dentist | 7312 Louetta Rd Ste B119, Spring, TX 77379-6176 | 2020-10-23 |
| 1750980025 | Neda Hani Tabaei Zavareh | Dentist | 10900 Twisted Elm Dr, Austin, TX 78726-2369 | 2020-10-19 |
| 1710586029 | Whitestone Dental Center Pllc | Dentist | 500 W Whitestone Blvd Ste 102, Cedar Park, TX 78613-2271 | 2020-10-19 |
| 1841899226 | Calvin Eastwood Dds Pllc | Dentist | 3088 Basswood Blvd # 150, Fort Worth, TX 76137-1676 | 2020-10-18 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.