Individual provider Active NPI

Sophia Siddiqi, M.D.

  • Family Medicine Physician
  • Houston, TX
National Provider Identifier
1962794263
Registry record updated Feb 3, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
Q3100 Issued in TX
Practice address
3701 Kirby Dr Ste 600
Houston, TX 77098-3926
Phone
(713) 867-8281
NPI assigned
May 5, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 3, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X Q3100 TX Primary

Addresses

Primary practice location

3701 Kirby Dr Ste 600
Houston, TX 77098-3926

Mailing address

3701 Kirby Dr Ste 600
Houston, TX 77098-3926

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
I20150320000525 TX Practitioner - Family Practice 8426375981 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jackson County Hospital DistrictGroup PAC ID 2365423795, shared by 7 NPIs, 20 clinicians

Practice addresses (Care Compare)

1013 S Wells St
Edna, TX 77957-4045
Phone (361) 782-7800

Hospital & facility affiliations

  • Jackson Healthcare Center Hospital, Edna, TX, CCN 451363

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
Q3100TXMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Jackson County Hospital District CurrentSince Jan 10, 2017 Accepting new patients
Baylor College of Medicine Family Medicine CurrentSince Feb 2, 2015 Accepting new patients
Baylor College of Medicine CurrentSince Feb 2, 2015 Accepting new patients
Jackson County Hospital District CurrentSince Jan 10, 2017 Accepting new patients
Jackson County Hospital District CurrentSince Jan 1, 2026 Accepting new patients

Locations

1013 S Wells St
Edna, TX 77957
Phone (361) 782-5241

1013A S Wells St
Edna, TX 77957
Phone (361) 782-3560

2 Greenway Plz
Ste 900
Houston, TX 77046
Phone (713) 798-1835

1504 Taub Loop
Houston, TX 77030
Phone (713) 873-2860

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 and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1304553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1422921600000",
    "number": "1962794263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3701 KIRBY DR STE 600",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770983926"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3701 KIRBY DR STE 600",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770983926",
            "telephone_number": "713-867-8281"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIDDIQI",
        "first_name": "SOPHIA",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-05-05",
        "last_updated": "2015-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "Q3100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.