Provider Demographics
NPI:1851827331
Name:TEXAS ASSOCIATES OF ENDOCRINOLOGY & DIABETES, P.A.
Entity type:Organization
Organization Name:TEXAS ASSOCIATES OF ENDOCRINOLOGY & DIABETES, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER OF ENTITY
Authorized Official - Prefix:
Authorized Official - First Name:MUHAMMAD
Authorized Official - Middle Name:SHAHARYAR
Authorized Official - Last Name:SIDDIQUI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:314-258-3659
Mailing Address - Street 1:4521 MEDICAL CENTER DR STE 400
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75069-6863
Mailing Address - Country:US
Mailing Address - Phone:214-547-7557
Mailing Address - Fax:469-631-7217
Practice Address - Street 1:4521 MEDICAL CENTER DR STE 400
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75069-6863
Practice Address - Country:US
Practice Address - Phone:214-547-7557
Practice Address - Fax:469-631-7217
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-03
Last Update Date:2023-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXQ5278207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX371179801Medicaid