Individual
SCOTT R STANISLAW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
601 ROCKMEAD DRIVE, KINGWOOD, TX 77339
(713) 486-7400
(281) 359-2816
Mailing address
601 ROCKMEAD DR, KINGWOOD, TX 77339-2107
(713) 486-7400
(281) 359-2816
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
K5219
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
096546903
—
TX
01
—
5116615
AETNA PROVIDER NUMBER
TX
Enumeration date
06/22/2005
Last updated
05/02/2019
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