Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223D0004X | Dentist Anesthesiologist | 34645 | TX |
NPI | 1154876035 |
---|---|
Provider Name | Dr. Abuzar Arshi Siddiqui |
First Address | Lynn, MA 01901-1314 |
Second Address | Alvin, TX 77511-2811 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/08/2016 |
Last Update Date | 21/08/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
39609401 | (05) | TX |