MEDICARE: DR. MURUGESAN M SIDDHAPPAN MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	26015	OK
2	207Q00000X	Family Medicine Physician	N1756	TX

General Provider Information

NPI Number	:	1104096437
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MURUGESAN M SIDDHAPPAN MD

Provider Business Mailing Address
First Line	:	4760 PRESTON RD
Second Line	:	SUITE 244-244
City	:	FRISCO
State	:	TX
Zip	:	75034-8548
Country	:	US
Telephone Number	:	940-387-3837
Fax Number	:	940-387-9924

Provider Business Practice Location Address
First Line	:	2210 SAN JACINTO BLVD
Second Line	:	STE 4
City	:	DENTON
State	:	TX
Zip	:	76205-7527
Country	:	US
Telephone Number	:	940-387-3837
Fax Number	:	940-387-9924

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/03/2008
Last Update Date	:	01/10/2017

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