If you are physician or physician’s office and you are referring a patient from your office to us, please provide us with the following information:
- Physician’s name and office phone number
- Office address
- Patient’s name
- Patient’s demographics including address, phone number, etc.
- Reason for referral
** Please provide insurance information that the patient has so that we can verify the patient before their visit.**
Any tests or labs that have been completed for Dr. Siddiqui to have on file before he sees the patients.
Please fax over the information to (817) 225-2719.
Please call our friendly office staff at (817) 225-2716 if you have any questions or need further information to refer a patient.
** THANK YOU FOR YOUR KIND REFERRALS!!**