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General NPI Number Information
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NPI Number | 1154636561
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Entity Type | Individual
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Provider Name | KASHIF AHMED SIDDIQUI MD
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Gender | Male
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Dates
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Enumeration Date | 08/10/2010
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Last Update Date | 09/10/2020
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Provider Practice Location Address
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Address Line | 11601 SHADOW CREEK PKWY SUITE # 111-139
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City | PEARLAND
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State | TX
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Zip | 77584-7283
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Country | US
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Telephone | 832-462-9574
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Fax | 281-786-3939
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Provider Business Mailing Address
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Address Line | 2405 BARTON SHORE DR
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City | PEARLAND
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State | TX
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Zip | 77584-3952
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Country | US
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Telephone | 832-462-9574
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Fax | 281-786-3939
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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 | 27031
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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 | P2788
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 207RG0300X
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Taxonomy Name | Geriatric Medicine (Internal Medicine) Physician
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License Number | P2788
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License Number State | TX
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Taxonomy #4
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number | BP10034162
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License Number State | TX
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Taxonomy #5
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | P2788
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License Number State | TX
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Taxonomy #6
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number | 27031
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License Number State | OK
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