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General NPI Number Information
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NPI Number | 1285661157
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Entity Type | Individual
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Provider Name | DANA L SISK MD
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Gender | Male
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Dates
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Enumeration Date | 06/27/2006
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Last Update Date | 01/26/2018
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Provider Practice Location Address
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Address Line | 2201 N STATE HIGHWAY 121
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City | BONHAM
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State | TX
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Zip | 75418-2345
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Country | US
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Telephone | 903-583-3111
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Fax | 903-583-1444
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Provider Business Mailing Address
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Address Line | 5012 S US HIGHWAY 75 STE 300 ATTN BILLING
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City | DENISON
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State | TX
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Zip | 75020-4589
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Country | US
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Telephone | 903-583-3111
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | E6174
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License Number State | TX
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