Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QS0010X | Family Doctor - Sports Medicine | Q0563 | TX |
NPI | 1023329190 |
---|---|
Provider Name | Mohammad Nameer Sidiquee |
First Address | Houston, TX 77014-1874 |
Second Address | Spring, TX 77379-2210 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/06/2010 |
Last Update Date | 11/09/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
Q0563 | TEXAS MEDICAL BOARD (01) | TX |