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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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