Provider Demographics
NPI:1366423691
Name:HOOVER, STANLEY THOMAS (MD)
Entity type:Individual
Prefix:DR
First Name:STANLEY
Middle Name:THOMAS
Last Name:HOOVER
Suffix:
Gender:M
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:PO BOX 52233
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70505-2233
Mailing Address - Country:US
Mailing Address - Phone:713-870-9036
Mailing Address - Fax:888-963-2009
Practice Address - Street 1:PO BOX 52233
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70505-2233
Practice Address - Country:US
Practice Address - Phone:713-870-9036
Practice Address - Fax:888-963-2009
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-14
Last Update Date:2024-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAL07862R208D00000X
LA07862R207LA0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LA0401XAllopathic & Osteopathic PhysiciansAnesthesiologyAddiction Medicine
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1392057Medicaid
LA1392057Medicaid