IndividualActive
Stanley Self, MD
NPI 1902946916 · Forensic Psychiatry Physician · Rusk, TX
Provider details
- NPI number
- 1902946916
- Entity type
- Individual
- Primary specialty
- Forensic Psychiatry PhysicianAllopathic & Osteopathic Physicians
- Credential
- MD
- Sex
- Male
- Sole proprietor
- No
- License
- H4693 (TX)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
1601 North Dickinson Drive
Rusk, TX 75785
Phone: (903) 683-3421
Approximate (ZIP-level) locationGet directions
Mailing address
17844 Sunset Strip
Flint, TX 75762-9447
Registry dates
- Enumerated
- 2007-02-07
- Last updated
- 2007-07-08
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.