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Organization

STANLEY SY MD PA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. LILIA CASTILLO QUEVEDO (OFFICE MANAGER)
(956) 424-1511
Entity
Organization

Contact information

Practice address
1040 W JEFFERSON ST, BROWNSVILLE, TX 78520
(956) 698-5400
Mailing address
805 W INSPIRATION DR, PHARR, TX 78577-6732
(956) 424-1511

Taxonomy

Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
M0587
TX
207RP1001X
Pulmonary Disease Physician
Primary
M0587
TX
207RS0012X
Sleep Medicine (Internal Medicine) Physician
M0587
TX
2080H0002X
Pediatric Hospice and Palliative Medicine Physician
M0587
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1740231893
NPI
TX
Enumeration date
05/11/2018
Last updated
07/29/2020
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