| Haroon Siddique, Md, Pa | |
|
902 Preskitt Rd Ste 200 Decatur TX 76234-4101 | |
| (940) 626-1848 | |
| (940) 626-1849 |
| Full Name | Haroon Siddique, Md, Pa |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 902 Preskitt Rd Ste 200, Decatur, Texas |
| Authorized Official Name and Position | Haroon W Siddique (PRESIDENT/OWNER) |
| Authorized Official Contact | 9406261848 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Haroon Siddique, Md, Pa 1816 S Fm 51 Suite 400, #130 Decatur TX 76234-3784 Ph: (940) 626-1848 | Haroon Siddique, Md, Pa 902 Preskitt Rd Ste 200 Decatur TX 76234-4101 Ph: (940) 626-1848 |
| NPI Number | 1467614768 |
|---|---|
| Provider Enumeration Date | 06/27/2008 |
| Last Update Date | 05/30/2022 |
| Certification Date | 05/30/2022 |
| Medicare PECOS PAC ID | 5092874057 |
|---|---|
| Medicare Enrollment ID | O20081203000908 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467614768 | NPI | - | NPPES |
| 0015RT | Other | TX | BCBS |
| 191149703 | Medicaid | TX | |
| 200570401 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | M6397 (Texas) | Primary |
| 273R00000X | Psychiatric Unit | M6397 (Texas) | Secondary |
| Provider Name | Haroon Wasil Siddique |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1457461519 PECOS PAC ID: 0244208262 Enrollment ID: I20080201000505 |
| Provider Name | Kimberly Warren |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982283438 PECOS PAC ID: 9133538838 Enrollment ID: I20210510002401 |
| Provider Name | Florence Ndali Nwokoye |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447878863 PECOS PAC ID: 1052706256 Enrollment ID: I20220325001470 |
| Provider Name | Karen J Contreras |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285358465 PECOS PAC ID: 0840662813 Enrollment ID: I20230221001885 |
| Provider Name | Shanique Mckittrick |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528833985 PECOS PAC ID: 5496191728 Enrollment ID: I20240308003410 |
| Provider Name | Jessica L Szatko |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174380117 PECOS PAC ID: 1557804812 Enrollment ID: I20240614003936 |
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