STANLEY SELF (NPI# 1902946916) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902946916 |
| Entity Type | Individual |
| Full Name | STANLEY SELF |
| Credential | MD |
| Practice Address |
1601 North Dickinson Drive Rusk TX 75785 |
| Mailing Address |
17844 Sunset Strip Flint TX 75762-9447 |
| Practice Telephone | 9036833421 |
| Mailing Telephone | 9036833421 |
| Enumeration Date | 2007-02-07 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084F0202X |
Psychiatry & Neurology Specialization: Forensic Psychiatry |
H4693 | TX | Allopathic & Osteopathic Physicians |
| Street Address |
1601 NORTH DICKINSON DRIVE |
| 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 |
| 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 |
| 1063423085 | Stacy Lee Black | Dentist | 132 Hatchett St., Rusk, TX 75785 | 2006-08-11 |
| Find all providers in zip 75785 | ||||
| Taxonomy Code | 2084F0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Forensic Psychiatry |
| Forensic Psychiatry is a subspecialty with psychiatric focus on interrelationships with civil, criminal and administrative law, evaluation and specialized treatment of individuals involved with the legal system, incarcerated in jails, prisons, and forensic psychiatry hospitals. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164689287 | Sarah Mallard Wakefield | Psychiatry & Neurology | 3601 4th St Stop 8104, Department of Psychiatry, Lubbock, TX 79430-8352 | 2008-05-16 |
| 1003037961 | Janice Bray | Psychiatry & Neurology | 3305 Northland Dr Ste 210, Austin, TX 78731 | 2007-05-01 |
| 1568582773 | Kenneth B. Dekleva | Psychiatry & Neurology | 6363 Forest Park Road, Suite 749, Dallas, TX 75390-9121 | 2007-03-30 |
| 1801956297 | Warren Harlan Charleston | Psychiatry & Neurology | 2750 South 8th Street, Building E, Beaumont, TX 77701 | 2006-12-08 |
| 1518038199 | Maureen Sarah Burrows | Psychiatry & Neurology | 510 Hearn St # 100, Austin, TX 78703 | 2006-11-13 |
| 1003992348 | Emilie Attwell | Psychiatry & Neurology | 6844 U.S. Highway 69 North, Lufkin State Supported Living Center, Pollok, TX 75969 | 2006-10-30 |
| 1225119787 | Barry Rosson | Psychiatry & Neurology | 8321 Summer Place Dr, Austin, TX 78759-8220 | 2006-10-18 |
| 1346346715 | Maria Ruiz Sweeney | Psychiatry & Neurology | 17503 Emerald Canyon Dr, San Antonio, TX 78232-5635 | 2006-09-15 |
| 1699786681 | Tracie Dejarnette-holly | Psychiatry & Neurology | 410 Pierce St Ste 103, Houston, TX 77002-8749 | 2006-08-11 |
| 1780615732 | Jose Esteban Igoa | Psychiatry & Neurology | 3600 N 23rd St, Suite 103, Mcallen, TX 78501-6144 | 2006-07-06 |
| 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.