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NPI Code Detail

MEDICARE: DR. LONNIE STANTON M.D.

MEDICARE: DR. LONNIE STANTON M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208600000XSurgery PhysicianH6964TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2080016232OTHERTXMED RR

General Provider Information

NPI Number : 1598762957
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. LONNIE STANTON M.D.
Provider Business Mailing Address
First Line : 351 N SAM HOUSTON BLVD
Second Line :
City : SAN BENITO
State : TX
Zip : 78586-4656
Country : US
Telephone Number : 956-399-2443
Fax Number : 956-399-6331
Provider Business Practice Location Address
First Line : 351 N SAM HOUSTON BLVD
Second Line :
City : SAN BENITO
State : TX
Zip : 78586-4656
Country : US
Telephone Number : 956-399-2443
Fax Number : 956-399-6331
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/30/2005
Last Update Date : 10/10/2011

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Directions to “ DR. LONNIE STANTON M.D.” Practice Location

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