Provider Demographics
NPI:1043249774
Name:RAWLS, STACEY LAWRENCE (MD)
Entity type:Individual
Prefix:DR
First Name:STACEY
Middle Name:LAWRENCE
Last Name:RAWLS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16310 TOMBALL PKWY UNIT 1503
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77064-1812
Mailing Address - Country:US
Mailing Address - Phone:832-301-0700
Mailing Address - Fax:
Practice Address - Street 1:16310 TOMBALL PKWY UNIT 1503
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77064-1812
Practice Address - Country:US
Practice Address - Phone:832-301-0700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-03
Last Update Date:2024-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2006-007722084P0800X
TXQ48312084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry