MEDICARE: MUZZIAN SIDDIQI M.D.

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	208000000X	Pediatrics Physician	L3127	TX

General Provider Information

NPI Number	:	1417958752
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MUZZIAN SIDDIQI M.D.

Provider Business Mailing Address
First Line	:	8080 N STADIUM DR
Second Line	:	200
City	:	HOUSTON
State	:	TX
Zip	:	77054-1829
Country	:	US
Telephone Number	:	832-824-6633
Fax Number	:	832-825-8901

Provider Business Practice Location Address
First Line	:	4410 NAVIGATION BLVD
Second Line	:	278
City	:	HOUSTON
State	:	TX
Zip	:	77011-1036
Country	:	US
Telephone Number	:	713-547-8282
Fax Number	:	713-547-8283

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

Provider Enumeration Date	:	08/09/2005
Last Update Date	:	07/08/2007

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