Provider Demographics
NPI:1275882136
Name:NIHAL U SIDDIQUI, MD, PA
Entity Type:Organization
Organization Name:NIHAL U SIDDIQUI, MD, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE PROPRIETOR
Authorized Official - Prefix:
Authorized Official - First Name:NIHAL
Authorized Official - Middle Name:U
Authorized Official - Last Name:SIDDIQUI
Authorized Official - Suffix:
Authorized Official - Credentials:MD, PA
Authorized Official - Phone:281-364-1960
Mailing Address - Street 1:9004 FOREST XING
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 XING
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
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-06
Last Update Date:2012-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK2592207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX10021474OtherAMERIGROUP
TX121333205Medicaid
TX121333204Medicaid
TX121333203Medicaid
TX0085BNOtherBLUECROSS BLUESHIELD
TX10021474OtherAMERIGROUP
TX121333204Medicaid