=====================================================
General NPI Number Information
=====================================================
NPI Number | 1932797388
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | GOLD STANDARD SLEEP PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/31/2020
-----------------------------------------------------
Last Update Date | 12/17/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 21134 MARKET RDG STE 102
-----------------------------------------------------
City | SAN ANTONIO
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78258-4986
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 210-322-4443
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 6868 SAN PEDRO AVE
-----------------------------------------------------
City | SAN ANTONIO
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78216-7201
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 210-415-0000
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | ALEX J MCKINLAY
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 210-865-6047
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207YS0012X
-----------------------------------------------------
Taxonomy Name | Sleep Medicine (Otolaryngology) Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 207Y00000X
-----------------------------------------------------
Taxonomy Name | Otolaryngology Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------