Provider Demographics
NPI:1346548922
Name:LILIANA SIFUENTES D.C., P.A.
Entity Type:Organization
Organization Name:LILIANA SIFUENTES D.C., P.A.
Other - Org Name:BALANCE FOR LIFE CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DOCTOR OF CHIROPRACTIC
Authorized Official - Prefix:DR
Authorized Official - First Name:LILIANA
Authorized Official - Middle Name:
Authorized Official - Last Name:SIFUENTES
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:915-751-9791
Mailing Address - Street 1:9005 DYER
Mailing Address - Street 2:SUITE B
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79904-1405
Mailing Address - Country:US
Mailing Address - Phone:915-751-9791
Mailing Address - Fax:915-751-0993
Practice Address - Street 1:9005 DYER ST STE B
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79904-1405
Practice Address - Country:US
Practice Address - Phone:915-751-9791
Practice Address - Fax:915-751-0993
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LILIANA SIFUENTES DC PA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-03-07
Last Update Date:2023-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
111N00000X
TX10726302R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
No302R00000XManaged Care OrganizationsHealth Maintenance OrganizationGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8L15536OtherMEDICARE PTAN
TX1033890586OtherNPI -INDIVIDUAL