Individual
DR. BRIAN DOUGLAS STAPP
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
11970 WILCREST DR, SUITE 101, HOUSTON, TX 77031-1923
(281) 933-9950
(281) 933-9953
Mailing address
11970 WILCREST DR, SUITE 101, HOUSTON, TX 77031-1923
(281) 933-9950
(281) 933-9953
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
16399
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
16399
STATE LICENSE #
TX
01
—
5395637
AETNA PROVIDER ID#
TX
01
—
86D552
BC/BS PROVIDER#
TX
Enumeration date
10/20/2006
Last updated
07/08/2007
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