Individual
STANLEY SELF
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1601 NORTH DICKINSON DRIVE, RUSK, TX 75785
(903) 683-3421
Mailing address
17844 SUNSET STRIP, FLINT, TX 75762-9447
(903) 683-3421
Taxonomy
Speciality
Code
Description
License number
State
2084F0202X
Forensic Psychiatry Physician
Primary
H4693
TX
Other
Enumeration date
02/07/2007
Last updated
07/08/2007
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