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General NPI Number Information
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NPI Number | 1174713606
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Entity Type | Organization
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Legal Business Name | STYLIANOS SIDERIS M.D., P.A.
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Dates
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Enumeration Date | 07/31/2007
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Last Update Date | 07/31/2007
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Provider Practice Location Address
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Address Line | 1330 E 6TH ST SUITE 305
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City | WESLACO
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State | TX
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Zip | 78596-4204
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Country | US
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Telephone | 956-447-3800
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Fax | 956-447-3803
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Provider Business Mailing Address
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Address Line | 1330 E 6TH ST SUITE 305
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City | WESLACO
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State | TX
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Zip | 78596-4204
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Country | US
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Telephone | 956-447-3800
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Fax | 956-447-3803
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | STYLIANOS SIDERIS
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Credential |
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Telephone | 956-447-3800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208800000X
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Taxonomy Name | Urology Physician
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License Number | M2235
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License Number State | TX
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