Provider Demographics
NPI:1588229181
Name:SIENTY, ERIK
Entity Type:Individual
Prefix:MR
First Name:ERIK
Middle Name:
Last Name:SIENTY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:116 COUNTY ROAD 2040
Mailing Address - Street 2:
Mailing Address - City:KLONDIKE
Mailing Address - State:TX
Mailing Address - Zip Code:75448-6449
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:113 AIRPORT RD STE 100
Practice Address - Street 2:
Practice Address - City:SULPHUR SPRINGS
Practice Address - State:TX
Practice Address - Zip Code:75482-2193
Practice Address - Country:US
Practice Address - Phone:903-439-4053
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-08
Last Update Date:2019-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2087747225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant