Provider Demographics
NPI:1225377328
Name:FERNANDO M. SILES, MD, PLLC
Entity Type:Organization
Organization Name:FERNANDO M. SILES, MD, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:FERNANDO
Authorized Official - Middle Name:MANUEL
Authorized Official - Last Name:SILES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:903-454-3300
Mailing Address - Street 1:2405 STONEWALL ST
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75401-3349
Mailing Address - Country:US
Mailing Address - Phone:903-454-3300
Mailing Address - Fax:
Practice Address - Street 1:2405 STONEWALL ST
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:TX
Practice Address - Zip Code:75401-3349
Practice Address - Country:US
Practice Address - Phone:903-454-3300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-08
Last Update Date:2020-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG70022084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent PsychiatryGroup - Single Specialty