Provider Demographics
NPI:1710779459
Name:ALAO, STACY
Entity type:Individual
Prefix:
First Name:STACY
Middle Name:
Last Name:ALAO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4015 BELT LINE RD STE 98B
Mailing Address - Street 2:
Mailing Address - City:ADDISON
Mailing Address - State:TX
Mailing Address - Zip Code:75001-4353
Mailing Address - Country:US
Mailing Address - Phone:254-527-5038
Mailing Address - Fax:
Practice Address - Street 1:4015 BELT LINE RD STE 98B
Practice Address - Street 2:
Practice Address - City:ADDISON
Practice Address - State:TX
Practice Address - Zip Code:75001-4353
Practice Address - Country:US
Practice Address - Phone:254-527-5038
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-19
Last Update Date:2025-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier