Organization
SIDDHARTHA RATH MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SIDDHARTHA RATH MD (OWNER)
(661) 203-4304
Entity
Organization
Contact information
Practice address
3215 OMEGA DR, ARLINGTON, TX 76014-2006
(661) 203-4304
Mailing address
204 STOCKTON DR, SOUTHLAKE, TX 76092-2224
(661) 203-4304
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
339868701
—
TX
Enumeration date
10/04/2018
Last updated
05/17/2021
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