MEDICARE: PATEL & SIGURDSON PLLC

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	122300000X	Dentist	31895	TX

General Provider Information

NPI Number	:	1861912735
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PATEL & SIGURDSON PLLC

Provider Business Mailing Address
First Line	:	2901 CITYPLACE WEST BLVD APT 603
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75204-0368
Country	:	US
Telephone Number	:	832-612-1123
Fax Number	:

Provider Business Practice Location Address
First Line	:	6434 E MOCKINGBIRD LN STE 215
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75214-2494
Country	:	US
Telephone Number	:	214-827-1885
Fax Number	:	214-827-1885

Authorized Official
Title or Position	:	OWNER
Name	:	SHAUN SIGURDSON
Credential	:	DDS
Telephone Number	:	832-612-1123

Provider Enumeration Date	:	06/22/2017
Last Update Date	:	05/22/2020

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