Provider Demographics
NPI:1558474817
Name:SIDDIQUI, KIRAN FATIMA (MD)
Entity Type:Individual
Prefix:DR
First Name:KIRAN
Middle Name:FATIMA
Last Name:SIDDIQUI
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Gender:F
Credentials:MD
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Mailing Address - Street 1:2620 LONG PRAIRIE ROAD
Mailing Address - Street 2:#100
Mailing Address - City:FLOWER MOUND
Mailing Address - State:TX
Mailing Address - Zip Code:75022
Mailing Address - Country:US
Mailing Address - Phone:817-240-0012
Mailing Address - Fax:972-724-2111
Practice Address - Street 1:5055 E BROADWAY BLVD
Practice Address - Street 2:C 104
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85711-3640
Practice Address - Country:US
Practice Address - Phone:520-623-9833
Practice Address - Fax:520-745-3870
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-17
Last Update Date:2022-06-06
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Provider Licenses
StateLicense IDTaxonomies
AZ338822084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry