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NPI Code Detail

MEDICARE: DR. SANOBER FATIMA SIDDIQUI O.D.

MEDICARE: DR. SANOBER FATIMA SIDDIQUI O.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1152W00000XOptometrist7717TGTX

General Provider Information

NPI Number : 1164791133
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SANOBER FATIMA SIDDIQUI O.D.
Provider Business Mailing Address
First Line : 10300 S WILCREST DR # 2008
Second Line :
City : HOUSTON
State : TX
Zip : 77099-2867
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3506 HIGHWAY 6 S
Second Line :
City : HOUSTON
State : TX
Zip : 77082-4204
Country : US
Telephone Number : 281-759-2020
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/21/2011
Last Update Date : 04/12/2012

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