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General NPI Number Information
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NPI Number | 1093995433
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Entity Type | Organization
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Legal Business Name | EVIE COLE INC.
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Dates
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Enumeration Date | 11/13/2007
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Last Update Date | 11/13/2007
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Provider Practice Location Address
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Address Line | 43 BESSDALE CT
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City | SPRING
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State | TX
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Zip | 77382-1676
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Country | US
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Telephone | 281-841-8696
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Fax |
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Provider Business Mailing Address
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Address Line | 43 BESSDALE CT
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City | SPRING
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State | TX
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Zip | 77382-1676
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Country | US
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Telephone | 281-841-8696
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. SAQIB A SIDDIQUI
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Credential | M.D.
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Telephone | 281-841-8696
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number | M0921
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License Number State | TX
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