Organization Active NPI

NW Cypress Pediatric and Family Medicine, PLLC

  • Pediatrics Physician
  • Houston, TX
National Provider Identifier
1386936292
Registry record updated Jan 26, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
72805 Issued in TX
Legal business name
NW CYPRESS PEDIATRIC AND FAMILY MEDICINE, PLLC
Practice address
11240 FM 1960 Rd W
Suite 210
Houston, TX 77065-3662
Phone
(281) 469-7400
Fax
(281) 469-7403
NPI assigned
May 11, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2012

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

Authorized official

Name
Dr. Tahrin Siddiqua, MDNPI 1285893123
Title
Owner/Physician
Phone
(281) 469-7400

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X
Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208000000X 72805 TX Primary

Addresses

Primary practice location

11240 FM 1960 Rd W
Suite 210
Houston, TX 77065-3662

Mailing address

11240 FM 1960 Rd W
Suite 210
Houston, TX 77065-3662
Phone (281) 469-7400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20111025000040 TX Part B Supplier - Clinic/Group Practice 6406029180 Receives reassigned benefits from 3 practitioners
Practice locations: Houston, TX; Cypress, TX

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D2030097NW Cypress Pediatrics and Family Medicine11240 FM 1960 Rd West, Suite 210, Houston, TX 77065Certificate of waiverSep 20, 2027

National Provider Directory

National Provider Directory

Locations

11853 Barker Cypress Rd
Ste 100
Cypress, TX 77433
Phone (281) 469-7400

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1305072000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1327536000000",
    "number": "1386936292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11240 FM 1960 RD W",
            "address_2": "SUITE 210",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770653662",
            "telephone_number": "281-469-7400",
            "fax_number": "281-469-7403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11240 FM 1960 RD W",
            "address_2": "SUITE 210",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770653662",
            "telephone_number": "281-469-7400",
            "fax_number": "281-469-7403"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NW CYPRESS PEDIATRIC AND FAMILY MEDICINE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-11",
        "last_updated": "2012-01-26",
        "status": "A",
        "authorized_official_last_name": "SIDDIQUA",
        "authorized_official_first_name": "TAHRIN",
        "authorized_official_title_or_position": "OWNER/PHYSICIAN",
        "authorized_official_telephone_number": "281-469-7400",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "72805",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.