Healthcare Provider Details

I. General information

NPI: 1689824443
Provider Name (Legal Business Name): MUHAMMAD AHMAR SIDDIQUI M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/29/2008
Last Update Date: 06/10/2025
Certification Date: 06/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

221 W COLORADO BLVD STE 525
DALLAS TX
75208-2312
US

IV. Provider business mailing address

5605 N MACARTHUR BLVD STE 740
IRVING TX
75038-2626
US

V. Phone/Fax

Practice location:
  • Phone: 214-960-5681
  • Fax: 214-960-5681
Mailing address:
  • Phone: 214-960-5681
  • Fax: 903-525-1254

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberN7175
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License NumberN7175
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberN7175
License Number StateTX
# 4
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNM
# 5
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License NumberN7175
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: