Provider Demographics
NPI:1427097146
Name:SIDDIQI, MUHAMMAD NAVEED (MD)
Entity type:Individual
Prefix:
First Name:MUHAMMAD NAVEED
Middle Name:
Last Name:SIDDIQI
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 1:1001 COLLEGE AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76104-3000
Mailing Address - Country:US
Mailing Address - Phone:817-336-6000
Mailing Address - Fax:817-336-2072
Practice Address - Street 1:1001 COLLEGE AVE
Practice Address - Street 2:SUITE A
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76104-3000
Practice Address - Country:US
Practice Address - Phone:817-336-6000
Practice Address - Fax:817-336-2072
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-06
Last Update Date:2011-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN6664207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXG31624Medicare UPIN