Provider Demographics
NPI:1316641913
Name:TASH MEDICALCLINIC LLC
Entity type:Organization
Organization Name:TASH MEDICALCLINIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TARIQ
Authorized Official - Middle Name:
Authorized Official - Last Name:SIDDIQUI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:502-533-3854
Mailing Address - Street 1:415 S MESA HILLS DR APT 1116
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79912-5477
Mailing Address - Country:US
Mailing Address - Phone:502-533-3854
Mailing Address - Fax:855-300-5330
Practice Address - Street 1:7812 GATEWAY BLVD E STE 120
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79915-1811
Practice Address - Country:US
Practice Address - Phone:502-533-3854
Practice Address - Fax:855-300-5330
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-28
Last Update Date:2023-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty