Provider Demographics
NPI:1255915971
Name:STANDARD MEDICAL
Entity type:Organization
Organization Name:STANDARD MEDICAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
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:210-859-7819
Mailing Address - Street 1:10700 MCPHERSON RD
Mailing Address - Street 2:
Mailing Address - City:LAREDO
Mailing Address - State:TX
Mailing Address - Zip Code:78045-6268
Mailing Address - Country:US
Mailing Address - Phone:956-523-2673
Mailing Address - Fax:855-952-2002
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:956-523-2673
Practice Address - Fax:855-952-2002
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-09
Last Update Date:2021-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty