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Ishreth Fatima Siddiqui

Family Medicine

Allopathic & Osteopathic Physicians

701 S Zarzamora St, San Antonio, TX 78207-5209

PECOS Enrollment

This provider is enrolled in PECOS as ISHRETH SIDDIQUI.

Based on the most recent information from CMS, provider Ishreth Fatima Siddiqui is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 2 days ago.

Profile Details

Provider ID
1710113659
Provider Type
Individual
Full Name
Siddiqui, Ishreth Fatima
Credential
MD

Gender
Female
Sole Proprietor
No
Enumeration Date
6/5/2009
Last Updated
9/20/2024

Contact Information

Practice Location

701 S Zarzamora St, San Antonio, TX 78207-5209

(210) 358-7474

(210) 358-7406

Mailing Location

PO Box 87, San Antonio, TX 78291-0087

(210) 358-9172

(210) 358-9183

Provider Taxonomies

Code	Description	License
Code 207Q00000X Primary	Description Family Medicine Allopathic & Osteopathic Physicians	License R1294 Texas

Ishreth Fatima Siddiqui

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Norris, Simone L

Feili, Ali

Benavides, Melissa Ann

Myers, Abigail C

Ellanti, Naga Pranavi

Cervantes, Jimena

Ravi, Tharani

Labahn, Jacob

Katipally, Bhoja R.

Andry, Nehman Moses