Basic Information
| Provider Information | |||||||||
| NPI: | 1316987779 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SIBAL | ||||||||
| FirstName: | AMAN | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 848491 | ||||||||
| Address2: | |||||||||
| City: | DALLAS | ||||||||
| State: | TX | ||||||||
| PostalCode: | 752848491 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2542029330 | ||||||||
| FaxNumber: | 2542029349 | ||||||||
| Practice Location | |||||||||
| Address1: | 100 HILLCREST MEDICAL BLVD | ||||||||
| Address2: | |||||||||
| City: | WACO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 767128897 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2542022000 | ||||||||
| FaxNumber: | 2542025651 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/07/2006 | ||||||||
| LastUpdateDate: | 10/30/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 10/30/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | D0061959 | MD | N | Allopathic & Osteopathic Physicians | Internal Medicine | 208M00000X | D0061959 | MD | N | Allopathic & Osteopathic Physicians | Hospitalist | 207R00000X | N9130 | TX | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
ID Information
| ID | Type | State | Issuer | Description | 405669800 | 05 | MD | MEDICAID | P00297876 | 01 | MD | R/R MEDICARE PROVIDER # | OTHER | CA8374 | 01 | MD | R/R MEDICARE GROUP # | OTHER |