Provider Demographics
NPI:1194715326
Name:SIDDIQI, MOHAMMAD I (MD)
Entity type:Individual
Prefix:DR
First Name:MOHAMMAD
Middle Name:I
Last Name:SIDDIQI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:17320 RED OAK DR
Mailing Address - Street 2:SUITE 210
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77090-2633
Mailing Address - Country:US
Mailing Address - Phone:281-580-1507
Mailing Address - Fax:281-580-1507
Practice Address - Street 1:17320 RED OAK DR
Practice Address - Street 2:SUITE 210
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77090-2633
Practice Address - Country:US
Practice Address - Phone:281-580-1500
Practice Address - Fax:281-580-1507
Is Sole Proprietor?:No
Enumeration Date:2005-10-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXK8840207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8755B1Medicare ID - Type Unspecified
H47315Medicare UPIN