Provider Demographics
NPI:1861634354
Name:MOTAMARRY, SILUS (MD)
Entity Type:Individual
Prefix:DR
First Name:SILUS
Middle Name:
Last Name:MOTAMARRY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:634 UPTOWN BLVD
Mailing Address - Street 2:
Mailing Address - City:CEDAR HILL
Mailing Address - State:TX
Mailing Address - Zip Code:75104-3507
Mailing Address - Country:US
Mailing Address - Phone:972-637-1300
Mailing Address - Fax:866-353-7586
Practice Address - Street 1:634 UPTOWN BLVD
Practice Address - Street 2:
Practice Address - City:CEDAR HILL
Practice Address - State:TX
Practice Address - Zip Code:75104-3507
Practice Address - Country:US
Practice Address - Phone:972-637-1300
Practice Address - Fax:866-353-7586
Is Sole Proprietor?:No
Enumeration Date:2009-03-30
Last Update Date:2016-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP1111207W00000X, 2082S0099X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
No2082S0099XAllopathic & Osteopathic PhysiciansPlastic SurgeryPlastic Surgery Within the Head and Neck
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXTXB151384OtherPTAN