Individual
MIMI M SICILIO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BS IN PT
Contact information
Practice address
1600 WOLF PEN CT, COLLEGE STATION, TX 77840-3169
(979) 739-9696
Mailing address
1600 WOLF PEN CT, COLLEGE STATION, TX 77840-3169
(979) 739-9696
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
1021400
TX
Other
Enumeration date
01/10/2020
Last updated
01/10/2020
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