MEDICARE: SHAH NAWEED SIDDIQI MD

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	207T00000X	Neurological Surgery Physician	J4515	TX

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

General Provider Information

NPI Number	:	1972552420
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHAH NAWEED SIDDIQI MD

Provider Business Mailing Address
First Line	:	PO BOX 12267
Second Line	:
City	:	SPRING
State	:	TX
Zip	:	77391-2267
Country	:	US
Telephone Number	:	281-469-0339
Fax Number	:

Provider Business Practice Location Address
First Line	:	13323 DOTSON RD STE 100
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77070-4538
Country	:	US
Telephone Number	:	281-469-0339
Fax Number	:	281-469-0369

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

Provider Enumeration Date	:	05/10/2006
Last Update Date	:	02/03/2022

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