Provider Demographics
NPI:1780172825
Name:SIERRA, ADAM EMMANUEL (MD)
Entity type:Individual
Prefix:
First Name:ADAM
Middle Name:EMMANUEL
Last Name:SIERRA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 75172
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60675-5172
Mailing Address - Country:US
Mailing Address - Phone:800-475-3698
Mailing Address - Fax:706-596-6723
Practice Address - Street 1:6065 MONTANA AVE STE A6
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79925-1837
Practice Address - Country:US
Practice Address - Phone:915-881-1900
Practice Address - Fax:706-596-6723
Is Sole Proprietor?:No
Enumeration Date:2018-04-24
Last Update Date:2025-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXS86552085R0202X
CAA1845122085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology