Individual
STANLEY W WHISENANT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4000 WESLEY ST STE D, GREENVILLE, TX 75401-9015
(945) 766-4457
(972) 777-9939
Mailing address
2931 RIDGE RD STE 101-159, ROCKWALL, TX 75032-6670
(945) 766-4457
(972) 777-9939
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
J7725
TX
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
J7725
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0053MT
BCBS TX
TX
01
—
395576
WELLCARE
TX
01
—
688993
AMBETTER
TX
01
—
8AE000
BCBS TX
TX
01
—
92272
AVAILITY
TX
01
—
J7725
TEX MEDICAL LICENSE
TX
Enumeration date
12/06/2006
Last updated
09/03/2024
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