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Organization
REPUBLIC HOSPITALISTS SERVICES PLLC
Active
Organization
REPUBLIC HOSPITALISTS SERVICES PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEVIN B STACKS MD (OWNER)
(903) 870-4609
Entity
Organization
Contact information
Practice address
500 N HIGHLAND AVE, SHERMAN, TX 75092-7354
(903) 870-4609
Mailing address
PO BOX 8845, FORT WORTH, TX 76124-0845
(817) 451-4208
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0051MY
BLUE CROSS BLUE SHIELD
TX
05
—
177702101
—
TX
05
—
200080500A
—
OK
Enumeration date
06/17/2006
Last updated
07/17/2008
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