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General NPI Number Information
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NPI Number | 1902048101
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Entity Type | Individual
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Provider Name | HUMA ATIQUE SIDDIQUI MD
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Gender | Female
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Dates
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Enumeration Date | 04/02/2009
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Last Update Date | 04/02/2009
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Provider Practice Location Address
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Address Line | 7400 MERTON MINTER ST PATHOLOGY AND LAB MED SERVICES MC113
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City | SAN ANTONIO
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State | TX
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Zip | 78229-4404
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Country | US
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Telephone | 210-617-5300
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Fax | 210-949-3611
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Provider Business Mailing Address
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Address Line | 23007 STEEPLE BLF
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City | SAN ANTONIO
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State | TX
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Zip | 78256-1603
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Country | US
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Telephone | 210-317-4386
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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 | 207ZP0102X
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Taxonomy Name | Anatomic Pathology & Clinical Pathology Physician
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License Number | M0920
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License Number State | TX
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