Organization Active NPI

Khaled Jabboury MD,PA

  • Hematology Specialist/Technologist
  • Houston, TX
National Provider Identifier
1174588313
Registry record updated Jan 10, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology Specialist/TechnologistTaxonomy code 246QH0000X
Legal business name
KHALED JABBOURY MD,PA
Practice address
12121 Richmond Ave
100
Houston, TX 77082-2432
Phone
(281) 558-5385
Fax
(281) 558-6589
NPI assigned
Apr 19, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2013

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

Authorized official

Name
Khaled Jabboury, MDNPI 1629064308
Title
Owner/President
Phone
(281) 558-5385

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology Specialist/TechnologistGroup: 193200000X MULTI-SPECIALTY GROUP 246QH0000X Primary

Addresses

Primary practice location

12121 Richmond Ave
100
Houston, TX 77082-2432

Mailing address

12121 Richmond Ave
100
Houston, TX 77082-2432
Phone (281) 558-5385

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140404000282 TX Part B Supplier - Clinic/Group Practice 4486886546 Receives reassigned benefits from 1 practitioner
Practice locations: Houston, TX

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1145404800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1357776000000",
    "number": "1174588313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12121 RICHMOND AVE",
            "address_2": "100",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770822432",
            "telephone_number": "281-558-5385",
            "fax_number": "281-558-6589"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12121 RICHMOND AVE",
            "address_2": "100",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770822432",
            "telephone_number": "281-558-5385",
            "fax_number": "281-558-6589"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KHALED JABBOURY MD,PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-19",
        "last_updated": "2013-01-10",
        "status": "A",
        "authorized_official_last_name": "JABBOURY",
        "authorized_official_first_name": "KHALED",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "281-558-5385",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "246QH0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist/Technologist, Pathology, Hematology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Jan 10, 2013; 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.