DR. MARK S. SICILIO (NPI# 1477514149) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1477514149 |
| Entity Type | Individual |
| Full Name | DR. MARK S. SICILIO |
| Credential | M.D. |
| Practice Address |
2900 E 29th St Ste 200 Bryan TX 77802-2623 |
| Mailing Address |
2900 E 29th St Ste 100 Bryan TX 77802-2623 |
| Practice Telephone | 9797768440 |
| Practice Fax Number | 8776015854 |
| Mailing Telephone | 9797768440 |
| Mailing Fax Number | 8776015854 |
| Enumeration Date | 2006-03-31 |
| Last Update Date | 2020-07-15 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | G0115 | TX | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | 1303125-02 | 05 | |
| TX | CSHCN | 1303125-03 | 01 |
| TX | 130312513 | 05 | |
| TX | RR/MEDICARE | 370017626 | 01 |
| TX | BLUE SHIELD | 84E416 | 01 |
| Street Address |
2900 E 29TH ST STE 200 |
| City | BRYAN |
| State | TX |
| Zip Code | 77802-2623 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548266679 | Irvin F Sabrsula Jr. | Family Medicine | 2900 E 29th St Ste 200, Bryan, TX 77802-2623 | 2005-06-23 |
| 1891157707 | Meredith Williamson | Psychologist | 2900 E 29th St Ste 200, Bryan, TX 77802-2623 | 2016-03-22 |
| 1457797375 | Brandon Williamson | Emergency Medicine | 2900 E 29th St Ste 200, Bryan, TX 77802-2623 | 2013-05-19 |
| 1972863223 | Amanda Elizabeth Bray | Family Medicine | 2900 E 29th St Ste 200, Bryan, TX 77802-2623 | 2012-05-21 |
| 1083996177 | Katherine E Blalock | Family Medicine | 2900 E 29th St Ste 200, Bryan, TX 77802-2623 | 2011-09-14 |
| 1508019001 | Rae Ann Adams | Family Medicine | 2900 E 29th St Ste 200, Bryan, TX 77802-2623 | 2008-10-28 |
| 1063699312 | Texas A&m University System Health Science Center | Clinic/Center | 2900 E 29th St Ste 200, Bryan, TX 77802-2623 | 2008-01-29 |
| 1033220942 | Amy L Waer | Surgery | 2900 E 29th St Ste 200, Bryan, TX 77802-2623 | 2006-08-31 |
| 1790893600 | Jennifer Diane Friedman | Obstetrics & Gynecology | 2900 E 29th St Ste 200, Bryan, TX 77802-2623 | 2006-08-29 |
| 1518979103 | Robert Pope | Family Medicine | 2900 E 29th St Ste 200, Bryan, TX 77802-2623 | 2006-08-12 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013476951 | Andrea Pittman | Student in an Organized Health Care Education/Training Program | Primary Care Medicine Department, College of Medicine, 2900 East 29th Street, Bryan, TX 77802 | 2019-03-19 |
| 1942789110 | Alicia Diane Ates | Dentist | 3001 Wildflower Drive, Suite #511, Bryan, TX 77802 | 2018-08-09 |
| 1588151682 | Metx LLC | Audiologist-Hearing Aid Fitter | 3030 E 29th St Ste 102, Bryan, TX 77802 | 2018-04-16 |
| 1073047437 | Abbi Messer | Family Medicine | 2900 29th Street, Suite 100, Bryan, TX 77802 | 2017-04-12 |
| 1265885180 | Scott Andrew Thayer | Dentist | 3811 Stoneparc Dr, Bryan, TX 77802 | 2016-07-15 |
| 1255792123 | Phoebe Mathew | Pharmacist | 3312 East 29th Street, Bryan, TX 77802 | 2016-03-18 |
| 1801253810 | Pearl Coleshill | Specialist/Technologist | 3121 University Drive E., Suite 100, Bryan, TX 77802 | 2016-01-21 |
| 1265847750 | Wesley Danielle Daniels | Dietitian, Registered | 3900-c Carter Creek Pkway, Bryan, TX 77802 | 2014-06-24 |
| 1235549098 | Regina V. Robertson | Home Health | 1121 Briarcrest Dr., Suite 102, Bryan, TX 77802 | 2014-05-02 |
| 1982024238 | Lampstand Nursing and Rehabilitation, Lp | Skilled Nursing Facility | 2001 E 29th Street, Bryan, TX 77802 | 2014-04-24 |
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| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114983178 | Damyanti S Patel | Pediatrics | 1201a Briarcrest Dr, Bryan, TX 77802-5223 | 2006-04-26 |
| 1962468066 | Celeste Lopez | Pediatrics | 442 W High St Ste 3, Bryan, OH 43506-1681 | 2006-04-26 |
| 1588660930 | Graciela Beatriz Villadoniga | Pediatrics | 2901 E 29th St Ste 123, Bryan, TX 77802-2691 | 2005-06-21 |
| 1699161273 | Surya Jacob | Pediatrics | 1301 Memorial Dr, Bryan, TX 77802 | 2015-04-10 |
| 1376733899 | Maria Cristina Manahan Soriano | Pediatrics | 2901 E 29th St Ste 123, Bryan, TX 77802-2691 | 2007-07-31 |
| 1144346123 | Luvenia E. Tantoco | Pediatrics | 442 W High St, Bryan, OH 43506-1681 | 2007-03-22 |
| 1376599043 | Kimberly L. Dillon | Pediatrics | 442 W High St, Bryan, OH 43506-1681 | 2006-05-25 |
| 1205822061 | Daniel D. Quigley | Pediatrics | 3370 S Texas Ave, Suite B, Bryan, TX 77802-3127 | 2005-09-26 |
| 1104812965 | Veena Anand | Pediatrics | 3370 S Texas Ave, #b, Bryan, TX 77802-3127 | 2005-09-26 |
| 1568458321 | Kimberly Iero Buenger | Pediatrics | 3370 S Texas Ave, #b, Bryan, TX 77802-3127 | 2005-09-26 |
| Find all providers in BRYAN | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.