=====================================================
General NPI Number Information
=====================================================
NPI Number | 1861634354
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | SILUS MOTAMARRY M.D.
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/30/2009
-----------------------------------------------------
Last Update Date | 09/17/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 5744 LYNDON B JOHNSON FWY STE 150
-----------------------------------------------------
City | DALLAS
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75240-6382
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 972-392-2020
-----------------------------------------------------
Fax | 972-392-4054
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 5744 LYNDON B JOHNSON FWY STE 150
-----------------------------------------------------
City | DALLAS
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75240-6382
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 972-392-2020
-----------------------------------------------------
Fax | 972-392-4054
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 2082S0099X
-----------------------------------------------------
Taxonomy Name | Plastic Surgery Within the Head and Neck (Plastic Surgery) Physician
-----------------------------------------------------
License Number | P1111
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 207W00000X
-----------------------------------------------------
Taxonomy Name | Ophthalmology Physician
-----------------------------------------------------
License Number | P1111
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------