Provider Demographics
NPI:1205936937
Name:SADIQ, MOBIN A (MD)
Entity type:Individual
Prefix:DR
First Name:MOBIN
Middle Name:A
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 1:11211 KATY FWY 305
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77079-2122
Mailing Address - Country:US
Mailing Address - Phone:832-962-8656
Mailing Address - Fax:888-316-9234
Practice Address - Street 1:11211 KATY FWY 305
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77079-2122
Practice Address - Country:US
Practice Address - Phone:832-962-8656
Practice Address - Fax:888-316-9234
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-23
Last Update Date:2015-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN8451208M00000X
NY223090208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYH54354Medicare UPIN
NY86S361Medicare ID - Type Unspecified
TXTXB131996Medicare PIN