Provider Demographics
NPI:1386746527
Name:STAINBACK, RAYMOND (MD)
Entity type:Individual
Prefix:MR
First Name:RAYMOND
Middle Name:
Last Name:STAINBACK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6624 FANNIN ST STE 2480
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-2309
Mailing Address - Country:US
Mailing Address - Phone:713-798-5570
Mailing Address - Fax:
Practice Address - Street 1:6624 FANNIN ST STE 2480
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-2309
Practice Address - Country:US
Practice Address - Phone:713-798-5570
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-01
Last Update Date:2025-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH5494207R00000X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX060033419OtherMCR RAILROAD
TX38170OtherAMERIGROUP
TX82T4DMOtherBCBS
TX101989501Medicaid
TX82T4DMOtherBCBS
TX101989501Medicaid