Provider Demographics
NPI:1366737678
Name:STRACK, STUART (ATP)
Entity type:Individual
Prefix:MR
First Name:STUART
Middle Name:
Last Name:STRACK
Suffix:
Gender:M
Credentials:ATP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3206 S NOLAN CT
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-6676
Mailing Address - Country:US
Mailing Address - Phone:713-409-2035
Mailing Address - Fax:866-375-4185
Practice Address - Street 1:4401 S PINEMONT DR
Practice Address - Street 2:SUITE 216
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77041-9327
Practice Address - Country:US
Practice Address - Phone:713-835-3389
Practice Address - Fax:866-963-4539
Is Sole Proprietor?:No
Enumeration Date:2011-06-15
Last Update Date:2011-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXATP 4534247200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other