Provider Demographics
NPI:1740331016
Name:STANHOPE, JOHN E (DO)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:E
Last Name:STANHOPE
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:425 W COLONIAL DR STE 303
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32804-6863
Mailing Address - Country:US
Mailing Address - Phone:830-730-5025
Mailing Address - Fax:830-730-4207
Practice Address - Street 1:1762 E COMMON ST
Practice Address - Street 2:
Practice Address - City:NEW BRAUNFELS
Practice Address - State:TX
Practice Address - Zip Code:78130-6059
Practice Address - Country:US
Practice Address - Phone:830-730-8580
Practice Address - Fax:830-327-1021
Is Sole Proprietor?:No
Enumeration Date:2007-01-15
Last Update Date:2024-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME989207Q00000X
TXG0637207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX419913501Medicaid
ME132920000Medicaid
E54052OtherHARVARD PILGRIM HEALTHCAR
MEE54052Medicare UPIN
E54052OtherHARVARD PILGRIM HEALTHCAR
MEP00069045Medicare PIN