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General NPI Number Information
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NPI Number | 1457713562
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Entity Type | Individual
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Provider Name | RAAHAT SIDDIQUI
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Gender | Male
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Dates
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Enumeration Date | 03/28/2016
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Last Update Date | 06/02/2025
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Provider Practice Location Address
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Address Line | 1675 REPUBLIC PKWY STE 104
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City | MESQUITE
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State | TX
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Zip | 75150-6902
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Country | US
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Telephone | 214-817-2457
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Fax | 214-393-5875
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Provider Business Mailing Address
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Address Line | 816 TULIP CT
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City | FORNEY
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State | TX
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Zip | 75126-2743
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Country | US
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Telephone | 714-723-1680
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Fax |
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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 | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 0-16-6975
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 1-22-59383
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License Number State | CA
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