Individual provider Active NPI

Thomas E Stanford Jr., MD

  • Internal Medicine Physician
  • Austin, TX
National Provider Identifier
1750480315
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
L1209 Issued in TX
Practice address
6705 W Highway 290
Austin, TX 78735-8400
Phone
(512) 785-1513
NPI assigned
Sep 21, 2006
Last updated
Jul 9, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X L1209 TX Primary

Addresses

Primary practice location

6705 W Highway 290
Austin, TX 78735-8400

Mailing address

6705 W Highway 290
Austin, TX 78735-8400
Phone (512) 785-1513

Other identifiers 1

IdentifierTypeStateIssuer
L1209OtherTXSTATE LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040607001337 TX Practitioner - Emergency MedicinePractitioner - Internal Medicine 2961307830 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
L1209TXMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Guadalupe Emergency Medicine Associates, PA CurrentSince Mar 1, 2018 Accepting new patients
Oleander Emergency Medicine Associates PA CurrentSince Apr 26, 2013 Accepting new patients
Taylor Emergency Medicine Associates PA Past Accepting new patients
Citizens Medical Center County of Victoria Past Accepting new patients
Hood Emergency Medicine Associates PA Past Accepting new patients
Chandor Emergency Physicians Past Accepting new patients
Hayes Creek Emergency Physicians Past Accepting new patients
Texas Em-1 Medical Services, PA Past Accepting new patients
Texas Em-1 Medical Services, PA Past Accepting new patients
Texas Emergency Room Services PA Past Accepting new patients
Camino Real Emergency Physicians PLLC Past Accepting new patients

Locations

2500 E Main St
Alice, TX 78332
Phone (361) 664-4376

1500 E Houston St
Beeville, TX 78102
Phone (361) 354-2000

2701 Hospital Dr
Victoria, TX 77901
Phone (361) 573-9180

Organizations & group practices 11

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1158796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1750480315",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6705 W HIGHWAY 290",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787358400",
            "telephone_number": "512-785-1513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6705 W HIGHWAY 290",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787358400",
            "telephone_number": "512-785-1513"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STANFORD",
        "first_name": "THOMAS",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-21",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "L1209",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "L1209",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

Verify at the official NPI Registry.