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General NPI Number Information
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NPI Number | 1003980475
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Entity Type | Individual
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Provider Name | OYETUNDE O SIYANBADE MD
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Gender | Male
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Dates
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Enumeration Date | 11/20/2006
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Last Update Date | 06/09/2022
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Provider Practice Location Address
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Address Line | 844 CENTRAL BLVD STE 260
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City | BROWNSVILLE
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State | TX
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Zip | 78520-7535
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Country | US
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Telephone | 956-435-0344
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Fax | 956-435-0420
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Provider Business Mailing Address
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Address Line | 2101 PEASE ST SUITE 1G
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City | HARLINGEN
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State | TX
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Zip | 78550-8307
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Country | US
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Telephone | 956-698-5138
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Fax | 956-698-4080
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 9913
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License Number State | ND
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Taxonomy #2
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Taxonomy Code | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number | 9913
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License Number State | ND
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Taxonomy #3
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | R0326
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License Number State | TX
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