Basic Information
| Provider Information | |||||||||
| NPI: | 1881981066 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SIY | ||||||||
| FirstName: | RICHARD | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 12121 RICHMOND AVE | ||||||||
| Address2: | SUITE 101 | ||||||||
| City: | HOUSTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 770822432 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2817415910 | ||||||||
| FaxNumber: | 7135831113 | ||||||||
| Practice Location | |||||||||
| Address1: | 12121 RICHMOND AVE | ||||||||
| Address2: | SUITE 101 | ||||||||
| City: | HOUSTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 770822432 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2817415910 | ||||||||
| FaxNumber: | 7135831113 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/07/2011 | ||||||||
| LastUpdateDate: | 12/17/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208200000X | BP10039711 | TX | Y | Allopathic & Osteopathic Physicians | Plastic Surgery |
No ID Information.