Provider Demographics
NPI:1285893123
Name:SIDDIQUA, TAHRIN (MD)
Entity type:Individual
Prefix:DR
First Name:TAHRIN
Middle Name:
Last Name:SIDDIQUA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12322 BLUFF HAVEN LN
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77433-3792
Mailing Address - Country:US
Mailing Address - Phone:806-928-4986
Mailing Address - Fax:
Practice Address - Street 1:11240 FM 1960 RD W
Practice Address - Street 2:SUITE 210
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77065-3662
Practice Address - Country:US
Practice Address - Phone:281-469-7400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-05
Last Update Date:2011-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN2805208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics