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General NPI Number Information
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NPI Number | 1528292901
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Entity Type | Organization
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Legal Business Name | IGOR SINIAKOV, M.D., P.A.
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Dates
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Enumeration Date | 05/13/2009
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Last Update Date | 05/13/2009
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Provider Practice Location Address
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Address Line | 3506 21ST ST STE 301
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City | LUBBOCK
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State | TX
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Zip | 79410-1212
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Country | US
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Telephone | 806-438-8938
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Fax |
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Provider Business Mailing Address
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Address Line | 3506 21ST ST STE 301
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City | LUBBOCK
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State | TX
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Zip | 79410-1212
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Country | US
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Telephone | 806-438-8938
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | IGOR SINIAKOV
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Credential | M.D.
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Telephone | 806-438-8938
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207ND0900X
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Taxonomy Name | Dermatopathology Physician
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License Number | M9660
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License Number State | TX
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