Provider Demographics
NPI:1437125481
Name:SIDDIQUI, MUHAMMAD ALI (MD)
Entity Type:Individual
Prefix:MR
First Name:MUHAMMAD
Middle Name:ALI
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 1:4405 ADRIEL LN
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75074-0335
Mailing Address - Country:US
Mailing Address - Phone:870-718-8384
Mailing Address - Fax:
Practice Address - Street 1:4405 ADRIEL LN
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75074-0335
Practice Address - Country:US
Practice Address - Phone:870-718-8384
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-28
Last Update Date:2023-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301502858207Q00000X
TN61863207Q00000X
ARE4343207Q00000X
GA87073207Q00000X
IN01084709A207Q00000X
TXR8828207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR157681001Medicaid
I30060Medicare UPIN
AR157681001Medicaid