MEDICARE: GOLD STANDARD SLEEP PLLC

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
1	207YS0012X	Sleep Medicine (Otolaryngology) Physician
2	207Y00000X	Otolaryngology Physician

General Provider Information

NPI Number	:	1932797388
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GOLD STANDARD SLEEP PLLC

Provider Business Mailing Address
First Line	:	6868 SAN PEDRO AVE
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78216-7201
Country	:	US
Telephone Number	:	210-415-0000
Fax Number	:

Provider Business Practice Location Address
First Line	:	21134 MARKET RDG STE 102
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78258-4986
Country	:	US
Telephone Number	:	210-322-4443
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	ALEX J MCKINLAY
Credential	:	MD
Telephone Number	:	210-865-6047

Provider Enumeration Date	:	12/31/2020
Last Update Date	:	12/17/2024

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