Provider Demographics
NPI:1821604000
Name:ZN HEALTHCARE SERVICES, PLLC
Entity Type:Organization
Organization Name:ZN HEALTHCARE SERVICES, PLLC
Other - Org Name:BROADWAY FAMILY CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KASHIF
Authorized Official - Middle Name:AHMED
Authorized Official - Last Name:SIDDIQUI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-462-9574
Mailing Address - Street 1:2405 BARTON SHORE DR
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-3952
Mailing Address - Country:US
Mailing Address - Phone:832-462-9574
Mailing Address - Fax:
Practice Address - Street 1:2405 BARTON SHORE DR
Practice Address - Street 2:
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77584-3952
Practice Address - Country:US
Practice Address - Phone:832-462-9574
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-22
Last Update Date:2021-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
No207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXP2788OtherLICENSE