Provider Demographics
NPI:1518979491
Name:SIKES, JANICE LEA (DO)
Entity Type:Individual
Prefix:DR
First Name:JANICE
Middle Name:LEA
Last Name:SIKES
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:2000 S LOOP 256
Mailing Address - Street 2:SUITE 124
Mailing Address - City:PALESTINE
Mailing Address - State:TX
Mailing Address - Zip Code:75801-5932
Mailing Address - Country:US
Mailing Address - Phone:903-723-9006
Mailing Address - Fax:903-723-1537
Practice Address - Street 1:2000 S LOOP 256
Practice Address - Street 2:SUITE 124
Practice Address - City:PALESTINE
Practice Address - State:TX
Practice Address - Zip Code:75801-5932
Practice Address - Country:US
Practice Address - Phone:903-723-9006
Practice Address - Fax:903-723-1537
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-12
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXJ7674207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXVADOOMedicare UPIN