Provider Demographics
NPI:1194011999
Name:SIDDIQUI, MUHAMMAD SHAHARYAR (MD)
Entity Type:Individual
Prefix:
First Name:MUHAMMAD
Middle Name:SHAHARYAR
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 1:4521 MEDICAL CENTER DR STE 400
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75069-6863
Mailing Address - Country:US
Mailing Address - Phone:214-547-7557
Mailing Address - Fax:469-631-7217
Practice Address - Street 1:4521 MEDICAL CENTER DR STE 400
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75069-6863
Practice Address - Country:US
Practice Address - Phone:214-547-7557
Practice Address - Fax:469-631-7217
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-21
Last Update Date:2023-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXQ5278207R00000X, 207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX365886602Medicaid