Provider Demographics
NPI:1174627442
Name:SYED, SADIQ A (MD)
Entity Type:Individual
Prefix:
First Name:SADIQ
Middle Name:A
Last Name:SYED
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 1:538 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:WINNIE
Mailing Address - State:TX
Mailing Address - Zip Code:77665-7600
Mailing Address - Country:US
Mailing Address - Phone:409-296-6000
Mailing Address - Fax:409-296-6381
Practice Address - Street 1:538 BROADWAY
Practice Address - Street 2:
Practice Address - City:WINNIE
Practice Address - State:TX
Practice Address - Zip Code:77665-7600
Practice Address - Country:US
Practice Address - Phone:409-296-6000
Practice Address - Fax:409-296-6381
Is Sole Proprietor?:No
Enumeration Date:2006-09-08
Last Update Date:2023-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301066837207R00000X
TXU0203207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI200000002860OtherPHP
MI1021671OtherMCLAREN HEALTH PLAN-MEDICAID
MI1021671OtherMCLAREN HEALTH PLAN-COMMERCIAL
MI1103302882OtherBLUE CROSS BLUE SHIELD
TX1174627442Medicaid
MI200000002860OtherPHP FAMILYCARE
MI1021671OtherMCLAREN HEALTH ADVANTAGE
MI4931040Medicaid
MI0M21440056OtherMEDICARE ADVANTAGE
MI7051397OtherAETNA
MI439818Medicaid
MI439818Medicaid