Provider Demographics
NPI:1699964882
Name:CHOI, STACY (PSYD)
Entity type:Individual
Prefix:DR
First Name:STACY
Middle Name:
Last Name:CHOI
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:STACY
Other - Middle Name:
Other - Last Name:PAIK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA
Mailing Address - Street 1:1110 NASA PKWY STE 545Q
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77058-3393
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1110 NASA PKWY STE 545Q
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77058-3393
Practice Address - Country:US
Practice Address - Phone:832-261-1432
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-23
Last Update Date:2024-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY 27532103TC0700X
TX38138103TC0700X, 103TC0700X
103TB0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral