Healthcare Provider Details

I. General information

NPI: 1780972042
Provider Name (Legal Business Name): HOUSTON NEURO SCIENCE PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/20/2011
Last Update Date: 07/20/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

38 LAKE STERLING GATE DR
SPRING TX
77379-7204
US

IV. Provider business mailing address

38 LAKE STERLING GATE DR
SPRING TX
77379-7204
US

V. Phone/Fax

Practice location:
  • Phone: 281-631-9658
  • Fax:
Mailing address:
  • Phone: 281-631-9658
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0600X
TaxonomyClinical Neurophysiology Physician
License Number
License Number State

VIII. Authorized Official

Name: SHAH SIDDIQI
Title or Position: OWNER
Credential: MD
Phone: 210-236-7266