Provider Demographics
NPI:1962592071
Name:WANG, STANLEY SUCHY (MD JD MPH)
Entity type:Individual
Prefix:
First Name:STANLEY
Middle Name:SUCHY
Last Name:WANG
Suffix:
Gender:M
Credentials:MD JD MPH
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Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:7800 SHOAL CREEK BLVD
Mailing Address - Street 2:SUITE 205N
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78757-1098
Mailing Address - Country:US
Mailing Address - Phone:512-206-4341
Mailing Address - Fax:512-407-1947
Practice Address - Street 1:2559 WESTERN TRAILS BLVD
Practice Address - Street 2:SUITE 100
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78745-1554
Practice Address - Country:US
Practice Address - Phone:512-899-2028
Practice Address - Fax:512-899-0311
Is Sole Proprietor?:No
Enumeration Date:2006-10-13
Last Update Date:2022-01-24
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXM8415207RS0012X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXTXB128535Medicare PIN
I68771Medicare UPIN
TX8K5269Medicare PIN