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Individual
STANLEY CARL PAETZOLD
Active
Individual
STANLEY CARL PAETZOLD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
K3375
TX
2080P0204X
Pediatric Emergency Medicine (Pediatrics) Physician
04-46442
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02320045
—
NM
01
—
04-46442
STATE MEDICAL LICENSE
KS
05
—
110700503
—
TX
01
—
14148503
CAQH
—
05
—
200033590A
—
OK
01
—
82940G
BLUE CROSS & BLUE SHIELD
TX
Enumeration date
10/18/2006
Last updated
12/18/2025
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