Individual
IMTIAZ SADIQ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
701 W 5TH ST, ODESSA, TX 79763-4206
(432) 703-5375
Mailing address
701 W 5TH ST, ODESSA, TX 79763-4206
(432) 703-5375
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
0101274561
VA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1325467980
—
TX
Enumeration date
04/09/2019
Last updated
09/06/2022
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