Provider Demographics
NPI:1114981321
Name:SIDDIQUI, NIHAL U (MD)
Entity Type:Individual
Prefix:
First Name:NIHAL
Middle Name:U
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 1:9004 FOREST CROSSING DR.
Mailing Address - Street 2:STE. B
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77381-1193
Mailing Address - Country:US
Mailing Address - Phone:281-364-1960
Mailing Address - Fax:281-364-1016
Practice Address - Street 1:9004 FOREST CROSSING DR.
Practice Address - Street 2:STE. B
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77381-1193
Practice Address - Country:US
Practice Address - Phone:281-364-1960
Practice Address - Fax:281-364-1016
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-14
Last Update Date:2012-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK2592207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX121333203Medicaid
TX760559868OtherCOMMERCIAL
TX0085BNOtherBLUE CROSS
TX10021474OtherAMERIGROUP
TX121333204Medicaid
TX121333204Medicaid
TX121333203Medicaid