Individual
MARK STALLS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
C.PED.
Contact information
Practice address
3106 SANTA MONICA DR, DENTON, TX 76205-8522
(940) 367-0641
(940) 383-4144
Mailing address
3106 SANTA MONICA DR, DENTON, TX 76205-8522
(940) 367-0641
(940) 383-4144
Taxonomy
Speciality
Code
Description
License number
State
405300000X
Prevention Professional
Primary
ABC CPED 1094
TX
Other
Enumeration date
03/08/2017
Last updated
03/08/2017
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