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NPI Code Detail

MEDICARE: ZARA MUSTAJAB SIDDIQUI D.O.

MEDICARE: ZARA MUSTAJAB SIDDIQUI D.O.
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
1207Q00000XFamily Medicine PhysicianU5523TX

General Provider Information

NPI Number : 1508211384
Entity Type Code : Individual
Provider Name (Legal Business Name) : ZARA MUSTAJAB SIDDIQUI D.O.
Provider Business Mailing Address
First Line : 4757 S 7TH ST
Second Line :
City : TERRE HAUTE
State : IN
Zip : 47802-4559
Country : US
Telephone Number : 812-234-2289
Fax Number : 812-232-4234
Provider Business Practice Location Address
First Line : 20423 KUYKENDAHL RD STE 100
Second Line :
City : SPRING
State : TX
Zip : 77379-3492
Country : US
Telephone Number : 281-500-8660
Fax Number : 281-500-8669
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/28/2016
Last Update Date : 06/17/2024

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