Organization
EDMONDSON ROSS & HURST MEMORIAL CLINIC PLLC
Active
Other names
MEMORIAL CLINIC
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KEVIN BRENT STACKS MD (SOLE MEMBER)
(903) 892-2781
Entity
Organization
Contact information
Practice address
600 N HIGHLAND AVE, SUITE 105, SHERMAN, TX 75092-5631
(903) 892-2781
(903) 892-2780
Mailing address
600 N HIGHLAND AVE, SUITE 104, SHERMAN, TX 75092-5631
(903) 870-4609
(903) 891-2025
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
K7908
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
195685601
—
TX
Enumeration date
05/20/2008
Last updated
03/15/2010
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