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General NPI Number Information
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NPI Number | 1225196637
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Entity Type | Organization
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Legal Business Name | JORGE A SIFUENTES MD PA
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Dates
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Enumeration Date | 12/05/2006
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Last Update Date | 05/13/2025
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Provider Practice Location Address
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Address Line | 713 DEAHL ST
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City | BORGER
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State | TX
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Zip | 79007-3522
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Country | US
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Telephone | 806-274-7057
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Fax | 806-274-2531
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Provider Business Mailing Address
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Address Line | 713 DEAHL ST
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City | BORGER
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State | TX
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Zip | 79007-3522
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Country | US
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Telephone | 806-274-7057
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Fax | 806-274-2531
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Authorized Official
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Title or Position | PRESIDENT
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Name | JORGE SIFUENTES
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Credential | MD
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Telephone | 806-274-7057
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | M0922
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License Number State | TX
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