Provider Demographics
NPI:1922546159
Name:STANDARD ANESTHESIA, PLLC
Entity Type:Organization
Organization Name:STANDARD ANESTHESIA, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ORGANIZER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:HUNTSINGER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:210-413-3642
Mailing Address - Street 1:13932 INTERSTATE 10 E
Mailing Address - Street 2:
Mailing Address - City:CONVERSE
Mailing Address - State:TX
Mailing Address - Zip Code:78109-3136
Mailing Address - Country:US
Mailing Address - Phone:210-413-3642
Mailing Address - Fax:888-681-5805
Practice Address - Street 1:10700 MCPHERSON RD
Practice Address - Street 2:
Practice Address - City:LAREDO
Practice Address - State:TX
Practice Address - Zip Code:78045-6268
Practice Address - Country:US
Practice Address - Phone:210-413-3642
Practice Address - Fax:888-681-5805
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-08
Last Update Date:2017-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL2331207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty