Provider Demographics
NPI:1578251005
Name:SHEPHERD, SIENA MICHELE (MD)
Entity Type:Individual
Prefix:
First Name:SIENA
Middle Name:MICHELE
Last Name:SHEPHERD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SIENA
Other - Middle Name:MICHELE
Other - Last Name:CONDON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:230 T C JESTER BLVD APT 517
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77007-3382
Mailing Address - Country:US
Mailing Address - Phone:281-777-0591
Mailing Address - Fax:
Practice Address - Street 1:4502 MEDICAL DR
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-4492
Practice Address - Country:US
Practice Address - Phone:210-910-3676
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-24
Last Update Date:2023-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program