Individual
AVA CHERYL STANCZAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
645 E STATE HIGHWAY 121 STE 600, COPPELL, TX 75019-7942
(972) 745-7500
(972) 745-4336
Mailing address
432 FARRIS MINES RD, ALLISONIA, VA 24347-4072
(540) 230-4668
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
01022011441
VA
208000000X
Pediatrics Physician
Primary
G4785
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0102201441
—
VA
Enumeration date
07/01/2005
Last updated
07/21/2022
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