Individual
DR. STACY COLOMBO BUTLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
6100 HARRIS PKWY STE 140, FORT WORTH, TX 76132-4130
(817) 346-5336
(817) 346-5366
Mailing address
2512 OLD TRINITY WAY, FORT WORTH, TX 76116-0517
(817) 346-5336
(817) 346-5366
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
N2037
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
205438901
—
TX
01
—
8AG791
BC/BS
—
Enumeration date
05/18/2007
Last updated
06/01/2011
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