Provider Demographics
NPI:1639309685
Name:SADIQ, SYED BAQER (MD)
Entity Type:Individual
Prefix:
First Name:SYED
Middle Name:BAQER
Last Name:SADIQ
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 1:2127 MANOR GREEN DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77077-6330
Mailing Address - Country:US
Mailing Address - Phone:228-234-9894
Mailing Address - Fax:
Practice Address - Street 1:17070 RED OAK DR STE 303
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77090-2616
Practice Address - Country:US
Practice Address - Phone:281-440-6066
Practice Address - Fax:281-440-7255
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-23
Last Update Date:2022-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXQ0355208VP0000X, 2084N0400X
MS221072084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX4093296Medicaid
MS03879829Medicaid