Provider Demographics
NPI:1972587129
Name:SHOSS, STANFORD M (MD)
Entity type:Individual
Prefix:
First Name:STANFORD
Middle Name:M
Last Name:SHOSS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:14140 SOUTHWEST FWY STE 200
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77478-3842
Mailing Address - Country:US
Mailing Address - Phone:281-649-7000
Mailing Address - Fax:713-484-6649
Practice Address - Street 1:16545 SOUTHWEST FWY
Practice Address - Street 2:SUITE 100
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77479-2891
Practice Address - Country:US
Practice Address - Phone:281-649-7200
Practice Address - Fax:281-491-6704
Is Sole Proprietor?:No
Enumeration Date:2005-12-01
Last Update Date:2019-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG0112207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX038484401Medicaid
TXC21787Medicare UPIN
TX00C310Medicare ID - Type Unspecified