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General NPI Number Information
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NPI Number | 1104096437
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Entity Type | Individual
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Provider Name | MURUGESAN M SIDDHAPPAN MD
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Gender | Male
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Dates
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Enumeration Date | 03/03/2008
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Last Update Date | 01/10/2017
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Provider Practice Location Address
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Address Line | 2210 SAN JACINTO BLVD STE 4
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City | DENTON
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State | TX
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Zip | 76205-7527
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Country | US
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Telephone | 940-387-3837
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Fax | 940-387-9924
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Provider Business Mailing Address
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Address Line | 4760 PRESTON RD SUITE 244-244
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City | FRISCO
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State | TX
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Zip | 75034-8548
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Country | US
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Telephone | 940-387-3837
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Fax | 940-387-9924
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 26015
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License Number State | OK
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | N1756
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License Number State | TX
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