Organization Active NPI

Habiba Medical Services Professional Corporation

  • Family Medicine Physician
  • Houston, TX
National Provider Identifier
1043499916
Registry record updated May 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
K6794 Issued in TX
Legal business name
HABIBA MEDICAL SERVICES PROFESSIONAL CORPORATION
Practice address
10039 Bissonnet St Ste 105
Houston, TX 77036-7838
Phone
(713) 771-5571
Fax
(713) 771-5514
NPI assigned
Oct 29, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 20, 2008

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

Authorized official

Name
Abdul Alhassan
Title
Owner
Phone
(713) 771-5572

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X K6794 TX Primary

Addresses

Primary practice location

10039 Bissonnet St Ste 105
Houston, TX 77036-7838

Mailing address

PO Box 420961
Houston, TX 77242-0961
Phone (713) 771-5572

Other identifiers 1

IdentifierTypeStateIssuer
146365501MedicaidTX

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040329001762 TX Part B Supplier - Clinic/Group Practice 3375435688 Receives reassigned benefits from 1 practitioner
Practice locations: Houston, TX

National Provider Directory

National Provider Directory

Locations

10039 Bissonnet St
Ste 300
Houston, TX 77036
Phone (713) 771-5572

Practitioners & affiliated clinicians

Practitioners 2

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": "1193616000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1211241600000",
    "number": "1043499916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 420961",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "772420961",
            "telephone_number": "713-771-5572",
            "fax_number": "713-771-5514"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10039 BISSONNET ST STE 105",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770367838",
            "telephone_number": "713-771-5571",
            "fax_number": "713-771-5514"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HABIBA MEDICAL SERVICES PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-29",
        "last_updated": "2008-05-20",
        "status": "A",
        "authorized_official_last_name": "ALHASSAN",
        "authorized_official_first_name": "ABDUL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "713-771-5572"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "K6794",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "146365501",
            "state": "TX"
        }
    ],
    "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 May 20, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.