Organization
RUSSELL PSYCHIATRY, PROFESSIONAL LIMITED LIABILITY COMPANY
Active
Organization
RUSSELL PSYCHIATRY, PROFESSIONAL LIMITED LIABILITY COMPANY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STACEY RUSSELL MD (MANAGER/LEAD PSYCHIATRIST)
(817) 726-9444
Entity
Organization
Contact information
Practice address
2006 S LOOP 336 W STE 500, CONROE, TX 77304-3315
(817) 726-9444
Mailing address
2006 S LOOP 336 W STE 500, CONROE, TX 77304-3315
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
Q6697
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1275945511
NPI DR. STACEY RUSSELL
TX
Enumeration date
03/28/2018
Last updated
03/28/2018
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