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General NPI Number Information
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NPI Number | 1134599327
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Entity Type | Individual
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Provider Name | SYDNEY LEIGH BIANCO PA-C
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Gender | Female
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Dates
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Enumeration Date | 09/30/2015
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Last Update Date | 12/31/2024
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Provider Practice Location Address
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Address Line | 6400 FANNIN ST STE 2500
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City | HOUSTON
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State | TX
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Zip | 77030-1537
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Country | US
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Telephone | 713-486-5075
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Fax |
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Provider Business Mailing Address
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Address Line | 139 RIVER ST REAR
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City | JESSUP
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State | PA
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Zip | 18434-1236
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Country | US
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Telephone | 570-204-7778
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Fax |
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | MA059086
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number | 019151
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA18380
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License Number State | TX
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