Provider Demographics
NPI:1235106758
Name:SADIQ, RAHEELA (MD)
Entity Type:Individual
Prefix:
First Name:RAHEELA
Middle Name:
Last Name:SADIQ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6300 W PARKER RD STE 128
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-8183
Mailing Address - Country:US
Mailing Address - Phone:972-981-8658
Mailing Address - Fax:972-981-8657
Practice Address - Street 1:6300 W PARKER RD STE 128
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-8183
Practice Address - Country:US
Practice Address - Phone:972-981-8658
Practice Address - Fax:972-981-8657
Is Sole Proprietor?:No
Enumeration Date:2006-03-02
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00037438207PE0005X, 207R00000X, 2083P0011X
WAMD00037483207R00000X
TXN2766207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207PE0005XAllopathic & Osteopathic PhysiciansEmergency MedicineUndersea and Hyperbaric Medicine
No2083P0011XAllopathic & Osteopathic PhysiciansPreventive MedicineUndersea and Hyperbaric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0170254OtherWA LABOR & INDUSTRIES
WA8247793Medicaid
WA912080948OtherGROUP HEALTH
WA912080948OtherREGENCE
WA912080948OtherFIRST HEALTH
WA912080948OtherTRICARE
WA912080948OtherPACIFICCARE/SECURE HORIZON
WADO1827OtherRAILROAD MEDICARE
WA912080948OtherCIGNA
WA912080948OtherAETNA INSURANCE
WA912080948OtherUNITED HEALTHCARE
WA912080948OtherFIRST CHOICE HEALTH PLANS
WA912080948OtherMOLINA
WA3130SAOtherREGENCE BLUE SHIELD
WA912080948OtherPRIVATE HEALTHCARE SYSTEM
WA912080948OtherKITSAP HEALTH PLANS
WA912080948OtherUNIFORM MEDICAL PLAN
WA912080948OtherPREMERA
WA912080948OtherCIGNA
WA912080948OtherMOLINA
WA8247793Medicaid