MEDICARE: PRISCILLA SIERK D.O.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0800X	Psychiatry Physician	L3479	TX

General Provider Information

NPI Number	:	1255352324
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PRISCILLA SIERK D.O.

Provider Business Mailing Address
First Line	:	3355 BEE CAVE RD
Second Line	:	SUITE 507
City	:	AUSTIN
State	:	TX
Zip	:	78746-6682
Country	:	US
Telephone Number	:	512-870-8180
Fax Number	:	512-852-6700

Provider Business Practice Location Address
First Line	:	3355 BEE CAVE RD
Second Line	:	SUITE 507
City	:	AUSTIN
State	:	TX
Zip	:	78746-6682
Country	:	US
Telephone Number	:	512-870-8180
Fax Number	:	512-852-6700

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/22/2006
Last Update Date	:	05/24/2012

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Practice Location Address:

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1871931428 — MS. SAMANTHA BRAY LCSW
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