Provider Demographics
NPI:1790739902
Name:SIEN HWIE LIE MD PA
Entity Type:Organization
Organization Name:SIEN HWIE LIE MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SIEN
Authorized Official - Middle Name:HWIE
Authorized Official - Last Name:LIE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:806-359-7746
Mailing Address - Street 1:711 N TAYLOR
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79107-5279
Mailing Address - Country:US
Mailing Address - Phone:806-359-7746
Mailing Address - Fax:806-359-8768
Practice Address - Street 1:711 N TAYLOR
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79107-5279
Practice Address - Country:US
Practice Address - Phone:806-359-7746
Practice Address - Fax:806-359-8768
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-20
Last Update Date:2014-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE8040208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX034737901Medicaid
160023990OtherRAILROAD MEDICARE
TX00LN63OtherBLUE CROSS BLUE SHIELD
TXC18415Medicare UPIN
351065Medicare PIN