Provider Demographics
NPI:1033381546
Name:SIDDIQI, NAUMAN (MD)
Entity Type:Individual
Prefix:
First Name:NAUMAN
Middle Name:
Last Name:SIDDIQI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 HAWN CT
Mailing Address - Street 2:
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75038-6273
Mailing Address - Country:US
Mailing Address - Phone:202-215-1585
Mailing Address - Fax:
Practice Address - Street 1:1110 COTTONWOOD LN
Practice Address - Street 2:# 105
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75038-6117
Practice Address - Country:US
Practice Address - Phone:972-607-2525
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-25
Last Update Date:2013-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA102498207R00000X
TXP3076207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX303083501Medicaid
TX303083502Medicaid
TX303083503Medicaid
TX303083501Medicaid
TXTXB160376Medicare PIN
TX303083503Medicaid
TXP01151561Medicare PIN