Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | BP10027674 | TX |
N | 111NI0900X | Internist | BP10027674 | TX |
Y | 207RC0200X | Critical Care Medicine | P8540 | TX |
NPI | 1063695336 |
---|---|
Provider Name | Atif Siddiqui |
First Address | Dallas, TX 75265-0865 |
Second Address | Houston, TX 77042-2549 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/12/2007 |
Last Update Date | 20/04/2018 |