Provider Demographics
NPI:1790096998
Name:KALIA, JUNAID SIDDIQ (MD)
Entity Type:Individual
Prefix:
First Name:JUNAID
Middle Name:SIDDIQ
Last Name:KALIA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1740 LONESOME DOVE DR
Mailing Address - Street 2:
Mailing Address - City:PROSPER
Mailing Address - State:TX
Mailing Address - Zip Code:75078
Mailing Address - Country:US
Mailing Address - Phone:469-954-0346
Mailing Address - Fax:469-954-0346
Practice Address - Street 1:1740 LONESOME DOVE DR
Practice Address - Street 2:
Practice Address - City:PROSPER
Practice Address - State:TX
Practice Address - Zip Code:75078
Practice Address - Country:US
Practice Address - Phone:469-954-0346
Practice Address - Fax:469-954-0346
Is Sole Proprietor?:No
Enumeration Date:2010-06-23
Last Update Date:2023-12-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA865642084N0400X
NC2020-045412084N0400X
MO2010017737390200000X
WI615142084N0400X
TXS38282084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1790096998Medicaid
UT1669470094OtherNEUROLOGY