Provider Demographics
NPI:1922588896
Name:CYPRESS SIGNATURE GASTROENTEROLOGY PLLC
Entity Type:Organization
Organization Name:CYPRESS SIGNATURE GASTROENTEROLOGY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SAMEER
Authorized Official - Middle Name:
Authorized Official - Last Name:SIDDIQUE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:346-666-6616
Mailing Address - Street 1:27700 NORTHWEST FWY STE 350
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77433-7749
Mailing Address - Country:US
Mailing Address - Phone:346-666-6616
Mailing Address - Fax:832-220-6768
Practice Address - Street 1:27700 NORTHWEST FWY STE 350
Practice Address - Street 2:
Practice Address - City:CYPRESS
Practice Address - State:TX
Practice Address - Zip Code:77433-7749
Practice Address - Country:US
Practice Address - Phone:346-666-1616
Practice Address - Fax:346-666-6613
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-20
Last Update Date:2020-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX393569401Medicaid