Provider Demographics
NPI:1366276347
Name:SIDYAN PLLC
Entity type:Organization
Organization Name:SIDYAN PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:ISHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:ADHIKARI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:210-500-3144
Mailing Address - Street 1:15100 NW MILITARY HWY
Mailing Address - Street 2:
Mailing Address - City:SHAVANO PARK
Mailing Address - State:TX
Mailing Address - Zip Code:78231-1527
Mailing Address - Country:US
Mailing Address - Phone:210-500-3144
Mailing Address - Fax:
Practice Address - Street 1:23610 IH 10 W STE 107
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78257-1750
Practice Address - Country:US
Practice Address - Phone:210-500-3144
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-30
Last Update Date:2024-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty