Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | K3468 | TX |
N | 111NI0900X | Internist | K3468 | TX |
Y | 207RG0100X | Gastroenterologist | K3468 | TX |
NPI | 1033301502 |
---|---|
Provider Name | Dr. Homayon Sidiq |
First Address | Pearland, TX 77584-7298 |
Second Address | Houston, TX 77025-1669 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/08/2007 |
Last Update Date | 21/06/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
118824503 | (05) | TX |
118824504 | (05) | TX |