Provider Demographics
NPI:1962465765
Name:SIEBERT, WILLIAM TERRY (MD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:TERRY
Last Name:SIEBERT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:1315 ST JOSEPH PKWY
Mailing Address - Street 2:SUITE 1710
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77002-8233
Mailing Address - Country:US
Mailing Address - Phone:713-757-7475
Mailing Address - Fax:713-659-3212
Practice Address - Street 1:1315 ST JOSEPH PKWY
Practice Address - Street 2:SUITE 1710
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77002-8233
Practice Address - Country:US
Practice Address - Phone:713-757-7475
Practice Address - Fax:713-659-3212
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXD9659207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0099593803Medicaid
TX8A0481Medicare ID - Type Unspecified
TX0099593803Medicaid