Individual
DR. KATHLEEN STANLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3601 4TH ST, SUITE 1C102, LUBBOCK, TX 79430-0002
(806) 743-2800
(806) 743-1668
Mailing address
PO BOX 5865, LUBBOCK, TX 79408-5865
(806) 743-2898
(806) 743-2787
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
G1268
TX
2084P0802X
Addiction Psychiatry Physician
G1268
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100845570A
—
OK
05
—
114700104
—
TX
05
—
22304550
—
NM
Enumeration date
12/19/2005
Last updated
07/13/2007
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