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9300 John Hickman Pkwy Ste 101 Frisco TX 75035-5939 | |
| (972) 781-0100 | |
| (972) 781-0101 |
| Full Name | |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 9300 John Hickman Pkwy Ste 101, Frisco, Texas |
| Authorized Official Name and Position | Lubna Siddiki (PRESIDENT) |
| Authorized Official Contact | 9727810100 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
9300 John Hickman Pkwy Ste 101 Frisco TX 75035-5939 Ph: (972) 781-0100 | 9300 John Hickman Pkwy Ste 101 Frisco TX 75035-5939 Ph: (972) 781-0100 |
| NPI Number | 1588081962 |
|---|---|
| Provider Enumeration Date | 03/24/2014 |
| Last Update Date | 09/03/2021 |
| Certification Date | 08/25/2020 |
| Medicare PECOS PAC ID | 2860617560 |
|---|---|
| Medicare Enrollment ID | O20140715000032 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588081962 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | M1347 (Texas) | Primary |
| Provider Name | Lubna Siddiki |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1497700942 PECOS PAC ID: 3971520172 Enrollment ID: I20051027000396 |
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