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General NPI Number Information
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NPI Number | 1366276347
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Entity Type | Organization
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Legal Business Name | SIDYAN PLLC
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Dates
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Enumeration Date | 08/30/2024
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Last Update Date | 08/30/2024
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Provider Practice Location Address
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Address Line | 23610 IH 10 W STE 107
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City | SAN ANTONIO
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State | TX
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Zip | 78257-1750
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Country | US
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Telephone | 210-500-3144
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Fax |
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Provider Business Mailing Address
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Address Line | 15100 NW MILITARY HWY
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City | SHAVANO PARK
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State | TX
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Zip | 78231-1527
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Country | US
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Telephone | 210-500-3144
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DR. ISHAN ADHIKARI
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Credential | MD
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Telephone | 210-500-3144
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number |
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License Number State |
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