Provider Demographics
NPI:1720047343
Name:HSIAO, MYRNA (DO)
Entity Type:Individual
Prefix:MRS
First Name:MYRNA
Middle Name:
Last Name:HSIAO
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5435 N GARLAND AVE
Mailing Address - Street 2:SUITE 140-183
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75040-2785
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5435 N GARLAND AVE
Practice Address - Street 2:SUITE 140-183
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75040-2785
Practice Address - Country:US
Practice Address - Phone:214-284-5514
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-22
Last Update Date:2010-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL8736208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX7991645OtherAETNA
TX00K83VMedicare UPIN
TX7991645OtherAETNA