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General NPI Number Information
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NPI Number | 1295228591
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Entity Type | Individual
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Provider Name | STEPHEN SIERRA MD
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Gender | Male
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Dates
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Enumeration Date | 06/11/2018
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Last Update Date | 06/30/2025
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Provider Practice Location Address
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Address Line | 7125 NEW SANGER AVE STE 516
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City | WACO
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State | TX
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Zip | 76712-4054
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Country | US
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Telephone | 254-752-9638
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Fax |
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Provider Business Mailing Address
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Address Line | 7125 NEW SANGER AVE STE 516
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City | WACO
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State | TX
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Zip | 76712-4054
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Country | US
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Telephone | 254-752-9638
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 207XX0005X
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Taxonomy Name | Sports Medicine (Orthopaedic Surgery) Physician
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License Number | T0136
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 207XX0005X
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Taxonomy Name | Sports Medicine (Orthopaedic Surgery) Physician
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License Number | 89582
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License Number State | SC
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