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General NPI Number Information
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NPI Number | 1790096998
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Entity Type | Individual
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Provider Name | JUNAID SIDDIQ KALIA M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/23/2010
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Last Update Date | 12/12/2023
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Provider Practice Location Address
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Address Line | 1740 LONESOME DOVE DR
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City | PROSPER
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State | TX
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Zip | 75078
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Country | US
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Telephone | 469-954-0346
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Fax | 469-954-0346
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Provider Business Mailing Address
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Address Line | 1740 LONESOME DOVE DR
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City | PROSPER
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State | TX
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Zip | 75078
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Country | US
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Telephone | 469-954-0346
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Fax | 469-954-0346
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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 | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | 86564
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | 2020-04541
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License Number State | NC
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Taxonomy #3
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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 | 2010017737
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License Number State | MO
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Taxonomy #4
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | 61514
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License Number State | WI
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Taxonomy #5
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | S3828
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License Number State | TX
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