Provider Demographics
NPI:1457461519
Name:SIDDIQUE, HAROON W (MD)
Entity Type:Individual
Prefix:DR
First Name:HAROON
Middle Name:W
Last Name:SIDDIQUE
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 1:1816 S FM 51
Mailing Address - Street 2:SUITE 400, #130
Mailing Address - City:DECATUR
Mailing Address - State:TX
Mailing Address - Zip Code:76234-3784
Mailing Address - Country:US
Mailing Address - Phone:940-626-1848
Mailing Address - Fax:940-626-1849
Practice Address - Street 1:902 PRESKITT RD STE 200
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:TX
Practice Address - Zip Code:76234-4101
Practice Address - Country:US
Practice Address - Phone:940-626-1848
Practice Address - Fax:940-626-1047
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2022-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM63972084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8BP530OtherBCBS
TX191149703Medicaid
TX191149702Medicaid