=====================================================
General NPI Number Information
=====================================================
NPI Number | 1023937398
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | EQUILIBRIUM HEALTH PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/13/2026
-----------------------------------------------------
Last Update Date | 07/13/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2801 NETWORK BLVD STE 300
-----------------------------------------------------
City | FRISCO
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75034-1881
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 816-863-3209
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2801 NETWORK BLVD STE 300
-----------------------------------------------------
City | FRISCO
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75034-1881
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 816-863-3209
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PROVIDER
-----------------------------------------------------
Name | SHAN SIDDIQI
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 816-863-3209
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 2084P0800X
-----------------------------------------------------
Taxonomy Name | Psychiatry Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------