Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | P2788 | TX |
N | 207Q00000X | Family Doctor | 27031 | OK |
N | 207Q00000X | Family Doctor | P2788 | TX |
N | 207RG0300X | Geriatric Medicine | P2788 | TX |
NPI | 1154636561 |
---|---|
Provider Name | Dr. Kashif Ahmed Siddiqui |
First Address | Pearland, TX 77584-3952 |
Second Address | Pearland, TX 77584-7283 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/08/2010 |
Last Update Date | 10/09/2020 |