Provider Demographics
NPI:1417766163
Name:SIDDIQUI, MUHAMMAD ALI SHAHBAZ (PSYD)
Entity type:Individual
Prefix:DR
First Name:MUHAMMAD ALI SHAHBAZ
Middle Name:
Last Name:SIDDIQUI
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2643 COUNTY ROAD 146
Mailing Address - Street 2:
Mailing Address - City:ALVIN
Mailing Address - State:TX
Mailing Address - Zip Code:77511-1361
Mailing Address - Country:US
Mailing Address - Phone:281-707-2711
Mailing Address - Fax:
Practice Address - Street 1:106 WHISPERING PINES AVE STE 103
Practice Address - Street 2:
Practice Address - City:FRIENDSWOOD
Practice Address - State:TX
Practice Address - Zip Code:77546-6211
Practice Address - Country:US
Practice Address - Phone:713-429-5325
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-06
Last Update Date:2025-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX40494103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical