Provider Demographics
NPI:1528292901
Name:IGOR SINIAKOV, M.D., P.A.
Entity type:Organization
Organization Name:IGOR SINIAKOV, M.D., P.A.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:IGOR
Authorized Official - Middle Name:
Authorized Official - Last Name:SINIAKOV
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:806-438-8938
Mailing Address - Street 1:3506 21ST ST
Mailing Address - Street 2:STE 301
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79410-1212
Mailing Address - Country:US
Mailing Address - Phone:806-438-8938
Mailing Address - Fax:
Practice Address - Street 1:3506 21ST ST
Practice Address - Street 2:STE 301
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79410-1212
Practice Address - Country:US
Practice Address - Phone:806-438-8938
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-13
Last Update Date:2009-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM9660207ND0900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207ND0900XAllopathic & Osteopathic PhysiciansDermatologyDermatopathologyGroup - Single Specialty