Provider Demographics
NPI:1740231893
Name:SY, STANLEY P (MD)
Entity Type:Individual
Prefix:
First Name:STANLEY
Middle Name:P
Last Name:SY
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 1:844 CENTRAL BLVD
Mailing Address - Street 2:SUITE 420
Mailing Address - City:BROWNSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78520-7552
Mailing Address - Country:US
Mailing Address - Phone:956-542-9900
Mailing Address - Fax:956-574-0003
Practice Address - Street 1:844 CENTRAL BLVD
Practice Address - Street 2:SUITE 420
Practice Address - City:BROWNSVILLE
Practice Address - State:TX
Practice Address - Zip Code:78520-7552
Practice Address - Country:US
Practice Address - Phone:956-542-9900
Practice Address - Fax:956-574-0003
Is Sole Proprietor?:No
Enumeration Date:2006-05-13
Last Update Date:2020-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM0587207R00000X, 207RC0200X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8V3285OtherBLUE CROSS BLUE SHIELD
TX177739304Medicaid
TX8V3450OtherBLUE CROSS BLUE SHIELD
TX177739305OtherMEDICAID CSN
TX8V3450OtherBLUE CROSS BLUE SHIELD
TX8D6517Medicare PIN