Sicilio, Mark S.

Sicilio, Mark S. is an individual health care provider with primary practice located at 2900 E 29Th St Ste 200 , Bryan TX 77802-2623. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Sicilio, Mark S. can be contacted via phone (979) 776-8440.

Contact Information

Primary practice address
2900 E 29Th St Ste 200 Bryan TX 77802-2623
Phone: (979) 776-8440
Fax: (877) 601-5854
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X G0115 Texas

Profile Details

NPI number 1477514149
LBN Legal business name Sicilio, Mark S.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 31st, 2006
Last updated Jul 15th, 2020 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1477514149 NPPES
Texas MEDICAID 130312513
Texas Other 84E416
Texas MEDICAID 1303125-02
Texas Other 370017626
Texas Other 1303125-03

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