MEDICARE: ABDULLAH J SIDDIQUI M.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
1	207R00000X	Internal Medicine Physician	R3755	TX
2	207R00000X	Internal Medicine Physician	A146504	CA
3	207RE0101X	Endocrinology, Diabetes & Metabolism Physician	R3755	TX
4	208M00000X	Hospitalist Physician	R3755	TX
5	208M00000X	Hospitalist Physician	A146504	CA
6	207RE0101X	Endocrinology, Diabetes & Metabolism Physician	A146504	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	374720602	OTHER	TX	CSHCN
3	R3755	OTHER	TX	TX MEDICAL LICENSE

General Provider Information

NPI Number	:	1598184459
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ABDULLAH J SIDDIQUI M.D

Provider Business Mailing Address
First Line	:	10745 W GRAND PKWY S STE 200
Second Line	:
City	:	RICHMOND
State	:	TX
Zip	:	77407-8713
Country	:	US
Telephone Number	:	282-275-0130
Fax Number	:

Provider Business Practice Location Address
First Line	:	10745 W GRAND PKWY S
Second Line	:
City	:	RICHMOND
State	:	TX
Zip	:	77407-8711
Country	:	US
Telephone Number	:	281-275-0130
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/08/2014
Last Update Date	:	01/20/2025

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