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Organization

SIADATI SURGICAL CONSULTING LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MOHAMMAD R SIADITI MD (OWNER/PHYSICIAN)
(972) 890-3459
Entity
Organization

Contact information

Practice address
2050 HALL JOHNSON RD STE 200, GRAPEVINE, TX 76051-8766
(817) 267-2678
Mailing address
2050 HALL JOHNSON RD STE 200, GRAPEVINE, TX 76051-8766

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary

Other

Enumeration date
11/13/2020
Last updated
11/13/2020
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