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General NPI Number Information
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NPI Number | 1235533886
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Entity Type | Organization
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Legal Business Name | WILLOWBROOK SPINE CENTER, P.A.
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Dates
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Enumeration Date | 10/10/2014
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Last Update Date | 10/10/2014
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Provider Practice Location Address
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Address Line | 9400 WESTHEIMER RD SUITE 2
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City | HOUSTON
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State | TX
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Zip | 77063-3414
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Country | US
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Telephone | 281-292-1121
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Fax |
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Provider Business Mailing Address
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Address Line | 9400 WESTHEIMER RD SUITE 2
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City | HOUSTON
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State | TX
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Zip | 77063-3414
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Country | US
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Telephone |
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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 SIDDIQUI
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Credential | M.D.
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Telephone | 832-547-0927
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207XS0117X
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Taxonomy Name | Orthopaedic Surgery of the Spine Physician
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License Number | M0921
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License Number State | TX
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