Provider Demographics
NPI:1821177940
Name:STONE, ERNEST L (MD)
Entity Type:Individual
Prefix:
First Name:ERNEST
Middle Name:L
Last Name:STONE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1501 E MOCKINGBIRD LN
Mailing Address - Street 2:STE 101
Mailing Address - City:VICTORIA
Mailing Address - State:TX
Mailing Address - Zip Code:77904-2178
Mailing Address - Country:US
Mailing Address - Phone:361-573-6291
Mailing Address - Fax:361-576-2434
Practice Address - Street 1:1501 E MOCKINGBIRD LN
Practice Address - Street 2:STE 101
Practice Address - City:VICTORIA
Practice Address - State:TX
Practice Address - Zip Code:77904-2155
Practice Address - Country:US
Practice Address - Phone:361-573-2481
Practice Address - Fax:361-576-2434
Is Sole Proprietor?:No
Enumeration Date:2006-11-02
Last Update Date:2019-10-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXH2813207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX742710179A010OtherCHAMPUS
TX123062502Medicaid
TX123062508Medicaid
TX87W118OtherBLUE CROSS
TX123062501Medicaid
TX123062508Medicaid
TX87W118Medicare PIN
TX123062508Medicaid