Organization
DFW FAMILY CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ADILA N. SIDDIQI D.O. (PHYSICIAN)
(972) 647-0550
Entity
Organization
Contact information
Practice address
2771 SHERMAN ST, GRAND PRAIRIE, TX 75051-6016
(972) 647-0550
Mailing address
2771 SHERMAN ST, GRAND PRAIRIE, TX 75051-6016
(972) 647-0550
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA09381
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PA09381
PHYSICIAN ASSISTANT PERMIT
TX
Enumeration date
05/29/2015
Last updated
05/29/2015
Update your record
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