Individual
DR. FARJAAD SIDDIQ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1715 WOLF CIR, LAKE CHARLES, LA 70605-2353
(337) 480-7499
(337) 480-7498
Mailing address
PO BOX 122525 DEPT 2525, DALLAS, TX 75312-0001
(337) 494-2921
(337) 494-6523
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
15753R
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1478199
—
LA
01
—
P00196869
RAILROAD MEDICARE
LA
Enumeration date
11/02/2005
Last updated
06/09/2022
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