Provider Demographics
NPI:1568773257
Name:SAM, STANLEY (MD)
Entity type:Individual
Prefix:DR
First Name:STANLEY
Middle Name:
Last Name:SAM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1512 TEASLEY LN
Mailing Address - Street 2:
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76205-7282
Mailing Address - Country:US
Mailing Address - Phone:972-347-2777
Mailing Address - Fax:972-347-2776
Practice Address - Street 1:26745 US HIGHWAY 380 E STE 112
Practice Address - Street 2:
Practice Address - City:AUBREY
Practice Address - State:TX
Practice Address - Zip Code:76227-8338
Practice Address - Country:US
Practice Address - Phone:972-347-2777
Practice Address - Fax:972-347-2776
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-28
Last Update Date:2025-06-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXR8822207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine