MEDICARE: SYDNEY LAYNE RUMORA PA-C

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	363A00000X	Physician Assistant		TX

General Provider Information

NPI Number	:	1316594815
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SYDNEY LAYNE RUMORA PA-C

Provider Business Mailing Address
First Line	:	19507 INDIAN HAWTHORN DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77094-2984
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3206 NORFOLK ST APT 14102
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77098-3809
Country	:	US
Telephone Number	:	940-783-3753
Fax Number	:

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

Provider Enumeration Date	:	08/20/2019
Last Update Date	:	01/06/2023

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