Provider Demographics
NPI:1093750770
Name:SIDDIQUI, JUNAID (MD)
Entity Type:Individual
Prefix:
First Name:JUNAID
Middle Name:
Last Name:SIDDIQUI
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 1:801 E WHITESTONE BLVD
Mailing Address - Street 2:STE. 201
Mailing Address - City:CEDAR PARK
Mailing Address - State:TX
Mailing Address - Zip Code:78613-5028
Mailing Address - Country:US
Mailing Address - Phone:512-341-0900
Mailing Address - Fax:512-341-2895
Practice Address - Street 1:801 E WHITESTONE BLVD
Practice Address - Street 2:STE. 201
Practice Address - City:CEDAR PARK
Practice Address - State:TX
Practice Address - Zip Code:78613-5028
Practice Address - Country:US
Practice Address - Phone:512-341-0900
Practice Address - Fax:512-341-2895
Is Sole Proprietor?:No
Enumeration Date:2006-06-18
Last Update Date:2014-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA36184207P00000X, 207RG0100X
TXM9653207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA36184OtherSTATE MEDICAL LICENSE
TXM9653OtherSTATE MEDICAL LICENSE
TXM9653OtherSTATE MEDICAL LICENSE