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General NPI Number Information
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NPI Number | 1700129228
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Entity Type | Individual
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Provider Name | LOREN C STANDLEE M.D.
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Gender | Male
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Dates
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Enumeration Date | 04/03/2013
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Last Update Date | 12/18/2022
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Provider Practice Location Address
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Address Line | 2027 S 61ST ST STE 109
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City | TEMPLE
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State | TX
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Zip | 76504-6856
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Country | US
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Telephone | 254-228-5291
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Fax |
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Provider Business Mailing Address
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Address Line | 2027 S 61ST ST STE 109
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City | TEMPLE
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State | TX
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Zip | 76504-6856
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Country | US
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Telephone | 918-804-2525
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | S8657
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 28090
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License Number State | NE
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Taxonomy #4
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Taxonomy Code | 171000000X
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Taxonomy Name | Military Health Care Provider
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License Number | 28090
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License Number State | NE
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