Basic Information
Provider Information
NPI: 1144234436
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: NYARKO
FirstName: STANLEY
MiddleName: J
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 7026 OLD KATY RD
Address2: STE 276
City: HOUSTON
State: TX
PostalCode: 770242187
CountryCode: US
TelephoneNumber: 7136217436
FaxNumber:  
Practice Location
Address1: 7026 OLD KATY RD STE 276
Address2:  
City: HOUSTON
State: TX
PostalCode: 770242187
CountryCode: US
TelephoneNumber: 7136217436
FaxNumber:  
Other Information
ProviderEnumerationDate: 07/29/2006
LastUpdateDate: 03/09/2017
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2085R0202X060949GAN Allopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
2085R0202X2007-01456NCN Allopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
2085R0202X251301NYN Allopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
2085R0202XTM00501TXY Allopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology

No ID Information.


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