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Individual

STANLEY P SY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
844 CENTRAL BLVD, SUITE 420, BROWNSVILLE, TX 78520-7552
(956) 542-9900
(956) 574-0003
Mailing address
844 CENTRAL BLVD, SUITE 420, BROWNSVILLE, TX 78520-7552
(956) 542-9900
(956) 574-0003

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
M0587
TX
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
M0587
TX
207RP1001X
Pulmonary Disease Physician
Primary
M0587
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
177739304
TX
01
177739305
MEDICAID CSN
TX
01
8V3285
BLUE CROSS BLUE SHIELD
TX
01
8V3450
BLUE CROSS BLUE SHIELD
TX
Enumeration date
05/13/2006
Last updated
07/29/2020
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