Provider Demographics
NPI:1811410319
Name:SIENNA DERMATOLOGY, PLLC
Entity Type:Organization
Organization Name:SIENNA DERMATOLOGY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANGEL
Authorized Official - Middle Name:SUN
Authorized Official - Last Name:PURYEAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:806-787-3661
Mailing Address - Street 1:7435 HIGHWAY 6 STE B
Mailing Address - Street 2:
Mailing Address - City:MISSOURI CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77459-4698
Mailing Address - Country:US
Mailing Address - Phone:832-342-9700
Mailing Address - Fax:
Practice Address - Street 1:7435 HIGHWAY 6 STE B
Practice Address - Street 2:
Practice Address - City:MISSOURI CITY
Practice Address - State:TX
Practice Address - Zip Code:77459-4698
Practice Address - Country:US
Practice Address - Phone:832-342-9700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-17
Last Update Date:2018-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty