Individual provider Active NPI

Imran A. Siddiqui, M.D.

  • Internal Medicine Physician
  • Temple, TX
National Provider Identifier
1821050238
Registry record updated Jul 11, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
L9908 Issued in TX
Practice address
2401 S 31St St
Temple, TX 76508-0001
Phone
(254) 724-2111
NPI assigned
Apr 3, 2006
Last updated
Jul 11, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X L9908 TX Primary

Addresses

Primary practice location

2401 S 31St St
Temple, TX 76508-0001

Mailing address

PO Box 847408
Dallas, TX 75284-7408
Phone (254) 724-2111

Other identifiers 4

IdentifierTypeStateIssuer
1672578-01MedicaidTX
1672578-01OtherTXCSHCN
8P1484OtherTXBLUE SHIELD
P00194565OtherTXRR/MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040921000784 TX Practitioner - Internal Medicine 2163490707 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
TMC PhysiciansGroup PAC ID 8921252081, 2 clinicians

Practice addresses (Care Compare)

10019 Main St
A1
Houston, TX 77025-5257
Phone (713) 666-7000

10019 S Main St
Suite A1
Houston, TX 77025-5257

4308 Allenbrook Dr
Baytown, TX 77521-3200
Phone (254) 493-0814

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Simcare, PLLC Internal Medicine CurrentSince Dec 1, 2020 Accepting new patients
Faiza Tahir MD PA CurrentSince Jan 4, 2023 Accepting new patients
Baytown Internal Medicine Associates PLLC Internal Medicine CurrentSince Oct 25, 2023 Accepting new patients
TMC Physicians Internal Medicine CurrentSince Dec 1, 2012 Accepting new patients
Busybody Fitness & Rehab, PLLC Past Accepting new patients

Locations

150 Blue Heron Pkwy
Baytown, TX 77521
Phone (281) 724-5442

1626 W Baker Rd
Baytown, TX 77521
Phone (281) 628-7300

4201 Garth Rd
Baytown, TX 77521
Phone (281) 420-8600

4308 Allenbrook Dr
Baytown, TX 77521
Phone (254) 493-0814

4401 Garth Rd
Baytown, TX 77521
Phone (281) 420-8500

6051 Garth Rd
Ste 1100
Baytown, TX 77521
Phone (346) 642-6891

10019 Main St
Ste A1
Houston, TX 77025
Phone (713) 666-7000

15149 Wallisville Rd
Houston, TX 77049
Phone (832) 400-2396

3801 Vista Rd
Ste 180
Pasadena, TX 77504
Phone (713) 359-2273

4000 Spencer Hwy
Pasadena, TX 77504
Phone (713) 359-1000

4600 E Sam Houston Pkwy S
Pasadena, TX 77505
Phone (713) 853-9302

4801 E Sam Houston Pkwy S
Pasadena, TX 77505
Phone (281) 991-5463

3129 Kingsley Dr
Ste 410
Pearland, TX 77584
Phone (281) 997-7333

2225 Williams Trace Blvd
Ste 110
Sugar Land, TX 77478
Phone (281) 491-1911

6720 Bertner Ave
Va Hospital, TX 77030
Phone (713) 785-8537

350 Blossom St
Webster, TX 77598
Phone (281) 316-7800

500 W Medical Center Blvd
Webster, TX 77598
Phone (713) 447-4650

709 W Medical Center Blvd
Webster, TX 77598
Phone (281) 316-8070

Interoperability endpoints

  • Direct secure messaging: isiddiqui66792@memorialhermann.direct-ci.com

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 11

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1144022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184112000000",
    "number": "1821050238",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 847408",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752847408",
            "telephone_number": "254-724-2111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2401 S 31ST ST",
            "city": "TEMPLE",
            "state": "TX",
            "postal_code": "765080001",
            "telephone_number": "254-724-2111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIDDIQUI",
        "first_name": "IMRAN",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-03",
        "last_updated": "2007-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "L9908",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1672578-01",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CSHCN",
            "identifier": "1672578-01",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "8P1484",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR/MEDICARE",
            "identifier": "P00194565",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Temple, TX

Sources for this page

Verify at the official NPI Registry.