Dynamica Concierge Associates

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

M7628 Issued in TX

Legal business name

DYNAMICA CONCIERGE ASSOCIATES

Practice address

355 E Parkwood Ave
Friendswood, TX 77546-5147

Phone

(310) 425-9880

NPI assigned

Mar 15, 2018

Last updated

Mar 15, 2018By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Khuram Siddiqi, MDNPI 1093859993

Title

President

Phone

(310) 425-9880

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Khuram Siddiqi, M.D.

  • Internal Medicine Physician
  • Sugar Land, TX
  • NPI 1093859993
  Medicare reassignment Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1521072000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1521072000000",
    "number": "1265935217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6410 LOGAN CREEK LN",
            "city": "SUGAR LAND",
            "state": "TX",
            "postal_code": "774793618",
            "telephone_number": "310-425-9880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "355 E PARKWOOD AVE",
            "city": "FRIENDSWOOD",
            "state": "TX",
            "postal_code": "775465147",
            "telephone_number": "310-425-9880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DYNAMICA CONCIERGE ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-03-15",
        "last_updated": "2018-03-15",
        "status": "A",
        "authorized_official_last_name": "SIDDIQI",
        "authorized_official_first_name": "KHURAM",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "310-425-9880",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "TX",
            "license": "M7628",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carra Dudley, PT, DPT
• Mai Duyen Duong, M.D.
• Bonnie Sue Dvorak, PHARMD
• Dyana Robbins Professional Limited Liability Company
• Dymurdie LLC
• James Stephen Eaves, D.D.S.
• Stacy L Ebert, D.C.
• Joanna Eckley, MA, LPC ASSOCIATE
• Edgewoodrx LLC (Edgewood Pharmacy)
• Edgewoodrx LLC (Edgewood Pharmacy)

• Clinic/Center in Friendswood, TX
• Providers in Friendswood, TX by specialty
• Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.