Provider Demographics
NPI:1629246533
Name:BRIAN E SICHER DPM PA
Entity Type:Organization
Organization Name:BRIAN E SICHER DPM PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:RACHELLE
Authorized Official - Middle Name:K
Authorized Official - Last Name:SICHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:806-353-3366
Mailing Address - Street 1:19 CARE CIR
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79124-2105
Mailing Address - Country:US
Mailing Address - Phone:806-353-3366
Mailing Address - Fax:806-353-0165
Practice Address - Street 1:19 CARE CIR
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79124-2105
Practice Address - Country:US
Practice Address - Phone:806-353-3366
Practice Address - Fax:806-353-0165
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-13
Last Update Date:2013-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1295332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX130987406Medicaid
TX480029628OtherRAILROAD MEDICARE
TXU55375Medicare UPIN
TX480029628OtherRAILROAD MEDICARE
TX5813580001Medicare NSC