Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | 9913 | ND |
N | 208600000X | Surgeon | 9913 | ND |
Y | 208200000X | Surgeon | R0326 | TX |
Y | 208600000X | Surgeon | R0326 | TX |
N | 2086S0129X | Vascular Surgeon | 9913 | ND |
NPI | 1003980475 |
---|---|
Provider Name | Oyetunde O Siyanbade |
First Address | Harlingen, TX 78550-8307 |
Second Address | Harlingen, TX 78550-8338 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/11/2006 |
Last Update Date | 08/06/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
13327 | (05) | ND |
367580301 | (05) | TX |
I24876 | (02) |