1275088965 NPI number — SIGI CYRIAC NP-C

Table of content: SIGI CYRIAC NP-C (NPI 1275088965)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1275088965 NPI number — SIGI CYRIAC NP-C

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CYRIAC
Provider First Name:
SIGI
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
NP-C
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1275088965
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/10/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 734812
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DALLAS
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75373-4812
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
210-358-9500
Provider Business Mailing Address Fax Number:
210-358-9183

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
19780 S US HIGHWAY 281
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SAN ANTONIO
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78221
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
210-626-0600
Provider Business Practice Location Address Fax Number:
210-626-1174
Provider Enumeration Date:
08/23/2016

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LF0000X , with the licence number:  AP131739 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)